Usefulness of Left Ventricular Diastolic Dysfunction Assessed by Pulsed Tissue Doppler Imaging as a Predictor of Atrial Fibrillation Recurrence After Successful Electrical Cardioversion

Caputo, Maria Luce; Urselli, Rossella; Capati, Eugenia; Navarri, Romina; Sinesi, Liliana; Furiozzi, F.; Ballo, Piercarlo; Palazzuoli, Alberto; Favilli, Roberto; Mondillo, Sergio

doi:10.1016/j.amjcard.2011.04.018

Cited by 29 publications

(31 citation statements)

References 24 publications

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“…This result might indicate that impairment of myocardial blood supply caused by coronary microvascular dysfunction makes an important contribution to LV diastolic dysfunction. Furthermore, because LV diastolic dysfunction plays a prominent role in creating an arrhythmogenic substrate, 18,19 our original findings present a plausible mechanism for early recurrence during the blanking period.…”

Section: Discussionmentioning

confidence: 77%

Effects of Iatrogenic Myocardial Injury on Coronary Microvascular Function in Patients Undergoing Radiofrequency Catheter Ablation of Atrial Fibrillation

Lim

Choi

et al. 2013

Circ: Arrhythmia and Electrophysiology

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Iatrogenic myocardial damage induced by RFCA releases proinflammatory substances into systemic circulation from the damaged myocardium, 6,7 and these provoke the perturbation of endothelial function in the coronary microvasculature. 8 This endothelial dysfunction may potentially induce diastolic dysfunction of the left ventricle (LV) and thereby contribute to early recurrence of arrhythmia after AF ablation. However, there was no data relating nonischemic myocardial damage to coronary microvascular function and LV diastolic function.In the present study, we aimed to determine whether iatrogenic myocardial injury provokes coronary microvascular Background-Iatrogenic myocardial injury by radiofrequency catheter ablation (RFCA) releases proinflammatory substances from damaged myocardium, and these may contribute to endothelial dysfunction in systemic vascular structure. The aim of this study is to evaluate the effect of nonischemic myocardial damage on coronary microvascular function in patients undergoing atrial fibrillation (AF) ablation. Methods and Results-We included 49 patients who underwent AF ablation (paroxysmal AF=25, persistent AF=24) and 34 controls. Immediately before and after RFCA, index of microvascular resistance (IMR) was assessed at left anterior descending coronary artery, and blood samples were obtained for analyses of nitric oxide (NO), activated leukocyte cell adhesion molecule, and lipoprotein-associated phospholipase. Transthoracic echocardiography was performed at baseline, 1 day, 1 month, and 3 months after RFCA. Compared with baseline, IMR, activated leukocyte cell adhesion molecule, and lipoprotein-associated phospholipase increased and NO decreased after RFCA. In 36 subjects with increasing IMR, E/E′ ratio increased at 1 day and returned to baseline level at 3 months after RFCA. Changes in activated leukocyte cell adhesion molecule and lipoprotein-associated phospholipase between baseline and after RFCA were independently related to the increase in IMR. In 14 subjects (28.6%), arrhythmia recurred. Using a cutoff value of 9.3 mm Hg/s, sensitivity was 56.7% and specificity was 91.2% for IMR change in predicting AF recurrence (P=0.028). Conclusions-Myocardial damage by RFCA provoked coronary microvascular dysfunction through systemic proinflammatory reaction that may contribute to transient diastolic dysfunction. This phenomenon may represent a mechanism for early recurrence of arrhythmia after RFCA. Clinical Trial Registration-URL: http://cris.nih.go.kr. Unique identifier: KCT0000030.(Circ Arrhythm Electrophysiol. 2013;6:318-326.)

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Section: Discussionmentioning

confidence: 77%

Effects of Iatrogenic Myocardial Injury on Coronary Microvascular Function in Patients Undergoing Radiofrequency Catheter Ablation of Atrial Fibrillation

Lim

Choi

et al. 2013

Circ: Arrhythmia and Electrophysiology

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“…strain may be used to assess different aspects of LV asynchrony [17]. Regional left lateral atrial longitudinal strain, left ventricular diastolic dysfunction and left atrial ultrasound reflectivity is a pre-procedural determinant of AF recurrence in patients undergoing ablation or electrical cardioversion [18][19][20]. In the study, radial strain was the most important independent predictor for maintenance of sinus rhythm during follow-up.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 87%

Left ventricular synchronization and systolic function estimated by speckle tracking echocardiography pre-and post-radiofrequency ablation in patients with atrial fibrillation

Zhang

Sun

Liu

et al. 2014

International Journal of Cardiology

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“…Changes in left ventricular filling pattern are connected to left atrial remodeling, which plays an important role in development as well as in perpetuation of AF 7. It was proven in previous studies, that presence of impaired left ventricular filling increases the risk of recurrent AF after successful electrical cardioversion (EC) as well as after successful ablation of AF 8,9. On the other hand it was recently shown that rapid atrial rhythm induces changes in endothelial parameters which could to some extent impair ventricular contractility and relaxation 10.…”

Section: Introductionmentioning

confidence: 99%

Changes in Left Ventricular Filling in Patients with Persistent Atrial Fibrillation

Naji¹,

Pagliaruzzi²,

Penko³

et al. 2013

Int. J. Med. Sci.

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BACKGROUND: Former studies showed possible interrelationship between altered ventricular filling patterns and atrial fibrillation (AF).HYPOTHESIS: Long term persistent AF has a negative impact on left ventricular filling in patients with preserved ejection fraction of left ventricle.METHODS: Our study was designed as a prospective case control study. We included 40 patients with persistent AF and preserved ejection fraction after successful electrical cardioversion and 43 control patients. Persistent AF was defined as AF lasting more than 4 weeks. Cardiac ultrasound was performed in all patients 24 hours after the procedure. Appropriate mitral flow and tissue Doppler velocities as well as standard echocardiographic measurements were obtained.RESULTS: There were no significant differences between both groups' parameters regarding age, sex, commorbidities or drug therapy. Analysis of mitral flow velocities showed significant increase of E value in AF group (0.96±0.27 vs.0.70±0.14; p = 0.001). Tissue Doppler measurements didn't reveal any differences in early diastolic movement, however there was a statistically significant difference in E/Em values of both groups, respectively (12.0±4.0 vs. 9.0±2.1; p= 0.001).CONCLUSION: Our study shows that in patients with preserved systolic function and persistent AF shortly after cardioversion diastolic ventricular filling patterns are altered mainly due to increased left atrial pressure and not due to impaired diastolic relaxation of left ventricle. Further studies are needed in order to define the interplay between diminished atrial function and impaired ventricular filling.

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Usefulness of Left Ventricular Diastolic Dysfunction Assessed by Pulsed Tissue Doppler Imaging as a Predictor of Atrial Fibrillation Recurrence After Successful Electrical Cardioversion

Cited by 29 publications

References 24 publications

Effects of Iatrogenic Myocardial Injury on Coronary Microvascular Function in Patients Undergoing Radiofrequency Catheter Ablation of Atrial Fibrillation

Effects of Iatrogenic Myocardial Injury on Coronary Microvascular Function in Patients Undergoing Radiofrequency Catheter Ablation of Atrial Fibrillation

Left ventricular synchronization and systolic function estimated by speckle tracking echocardiography pre-and post-radiofrequency ablation in patients with atrial fibrillation

Changes in Left Ventricular Filling in Patients with Persistent Atrial Fibrillation

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