Relation of Left Atrial Dysfunction to Ischemic Stroke in Patients With Coronary Heart Disease (from the Heart and Soul Study)

Wong, Jonathan; Welles, Christine C.; Azarbal, Farnaz; Whooley, Mary A.; Schiller, Nelson B.; Turakhia, Mintu P.

doi:10.1016/j.amjcard.2014.02.021

Cited by 35 publications

(41 citation statements)

References 29 publications

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“…Recently, Wong et al reported that the left atrial function index (LAFI) is a predictor of cerebral infarction [6]; Welles et al have also shown that LAFI is a predictor of hospitalization for heart failure [7]. Importantly, in these studies in which coronary heart disease (CHD) and preserved left ventricular ejection fraction (LVEF) were assessed, these authors reported a direct link between left atrial dysfunction and these complications independently of the presence of AF.…”

Section: Introductionmentioning

confidence: 94%

“…The heart rate was from 60 to 100 beats per minute during these measurements. As previously described [6,7], we calculated LAFI according to the following formula: and BSA ¼ body surface area m 2 À Á All of these values were obtained before the CA and each follow-up time of TTE. TTE recording was performed during sinus rhythm after the CA, but it was performed during AF for CAF patients before CA.…”

Section: Echocardiographymentioning

confidence: 99%

“…We set our cutoff value for normal LAFI at 30 based on our findings in the control group and previous reports [6,7]. Because Wong et al [6] and Welles et al [7] have reported good clinical outcomes in terms of stroke and hospitalization for heart failure when the LAFI is >30, we considered 30 an appropriate cutoff value for normal LAFI. We allocated patients to one of the following two groups according to their LAFI at final follow-up: the L group (LAFI <30) and N group (LAFI ≥30) (Fig.…”

Section: Echocardiographymentioning

confidence: 99%

“…Recently, Wong et al [6] and Welles et al [7] reported that LAFI, which can be assessed by TTE and is therefore a simpler and more repeatable measure than those obtained by TEE, may be a predictor of occurrence of stroke and hospitalization for heart failure. However, their studies were of patients with coronary heart disease and preserved LVEF.…”

Section: Advantages Of Lafimentioning

confidence: 99%

“…Because Wong et al investigated the relationship between LAFI and stroke only in patients with CHD [6], it has not yet been determined whether LAFI is a predictor of stroke in all AF patients irrespective of the presence of CHD. Because stroke occurs less frequently in patients without CHD, the appropriate cutoff value of LAFI for such patients may be larger than that used in this study.…”

Section: Study Limitationsmentioning

confidence: 99%

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Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

Nagase

Kato

Nakano

et al. 2015

J Interv Card Electrophysiol

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Section: Introductionmentioning

confidence: 94%

Section: Echocardiographymentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

Section: Advantages Of Lafimentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

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Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

Nagase

Kato

Nakano

et al. 2015

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show abstract

JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias

Ono¹,

Iwasaki²,

Akao³

et al. 2022

Journal of Arrhythmia

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Left atrial function index (LAFI) and outcome in patients undergoing transcatheter aortic valve replacement

et al. 2022

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Background Clinical data regarding the association between the left atrial function index (LAFI) and outcome in patients undergoing transcatheter aortic valve replacement (TAVR) are limited. Objectives We aimed to investigate the association between the left atrial function index (LAFI) and outcome in patients undergoing TAVR. Methods In this retrospective multicenter study, we assessed baseline LAFI in 733 patients undergoing TAVR for severe aortic stenosis in two German high-volume centers between 2008 and 2019. Based on receiver operating characteristic curves, patients were stratified according to their baseline LAFI into two groups (LAFI ≤ 13.5 vs. LAFI > 13.5) and assessed for post-procedural outcome. The primary endpoint of our study was the 1-year all-cause mortality. Results Patients with a LAFI ≤ 13.5 had significantly more often atrial fibrillation (p < 0.001), lower LVEF (p < 0.001) and higher levels of NT-proBNP (p < 0.001). After TAVR, a significant improvement in the LAFI as compared to baseline was observed at 12 months after the procedure (28.4 vs. 32.9; p = 0.001). Compared to patients with a LAFI > 13.5, those with a LAFI ≤ 13.5 showed significantly higher rate of 1-year mortality (7.9% vs. 4.0%; p = 0.03). A lower LAFI has been identified as independent predictor of mortality in multivariate analysis (HR (95% CI) 2.0 (1.1–3.9); p = 0.03). Conclusion A reduced LAFI is associated with adverse outcome and an independent predictor of mortality in TAVR patients. TAVR improves LAFI within 12 months after the procedure. Graphical abstract Left Atrial Function Index (LAFI) in Patients undergoing Transcatheter Aortic Valve Implantation. A Kaplan–Meier survival analysis of 1-year all-cause mortality in patients with LAFI ≤ 13.5 compared with patients with LAFI > 13.5. Comparing rates of 1-year all-cause mortality between the different LAFI groups, we found a significant association between left atrial function and mortality. LAFI Left atrial function index. B Comparison of the mean LAFI before and after TAVR. After long-term follow-up the LAFI improved significantly. LAFI Left atrial function index; FU follow-up. C Assessment of the left atrial function index using the pre-procedural transthoracic echocardiography. A Measurement of the minimal left atrial volume (LAEDV). B Assessment of the maximal left atrial volume (LAESV).

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Relation of Left Atrial Dysfunction to Ischemic Stroke in Patients With Coronary Heart Disease (from the Heart and Soul Study)

Cited by 35 publications

References 29 publications

Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

Prediction of improvement in left atrial function index after catheter ablation for atrial fibrillation

JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias

Left atrial function index (LAFI) and outcome in patients undergoing transcatheter aortic valve replacement

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