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Clinical correlates of echocardiographic tissue velocity imaging abnormalities of the left atrial wall during atrial fibrillation.
- Source :
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Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2014 Nov; Vol. 16 (11), pp. 1546-53. Date of Electronic Publication: 2014 Mar 25. - Publication Year :
- 2014
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Abstract
- Aims: In patients with atrial fibrillation (AF), echocardiographic tissue velocity imaging (TVI) enables assessment of electrical and structural remodelling by measuring, respectively, the AF cycle length (AFCL-TVI) and the atrial fibrillatory wall motion velocity (AFV-TVI). We investigated the clinical and echocardiographic correlates of atrial remodelling assessed by TVI.<br />Methods and Results: We studied 215 patients presenting with AF. In all patients, we measured the AFCL-TVI and the AFV-TVI in the left atrium. Standard baseline characteristics were recorded. We divided patients by median value of AFV-TVI and AFCL-TVI to evaluate the determinants of atrial remodelling. A low AFV-TVI was related with a longer median duration of the current AF episode, a higher prevalence of significant mitral regurgitation and a thicker left ventricle (LV). Multivariate analysis revealed that a low AFV-TVI was independently associated with a longer median duration of the current AF episode [OR 0.09 (95% CI 0.03-0.027); P < 0.001]. Univariately, a short AFCL-TVI was associated with a long median duration of the current AF episode, the use of anti-arrhythmic drugs, a lower LV ejection fraction (LVEF) and a smaller left atrial volume index (LAVI). Multivariate analysis revealed that LVEF [OR 1.48 (95% CI 1.09-2.01); P = 0.013] and LAVI [OR 1.37 (95% CI 1.08-1.74); P = 0.010] were independently associated with AFCL-TVI.<br />Conclusion: This study investigated the clinical and echocardiographic correlates of atrial remodelling assessed by TVI. The AFV-TVI is reduced in patients with a long AF duration and who have mitral regurgitation. In addition, the AFCL is long if LAVI is high and LVEF preserved. Tissue velocity imaging parameters measured during AF may be helpful to characterize the degree of atrial remodelling and optimize treatment.<br /> (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
- Subjects :
- Aged
Anti-Arrhythmia Agents therapeutic use
Atrial Fibrillation drug therapy
Atrial Fibrillation physiopathology
Cross-Sectional Studies
Female
Heart Atria drug effects
Heart Atria physiopathology
Humans
Linear Models
Male
Middle Aged
Mitral Valve Insufficiency diagnostic imaging
Mitral Valve Insufficiency physiopathology
Multivariate Analysis
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Stroke Volume
Time Factors
Ventricular Function, Left
Atrial Fibrillation diagnostic imaging
Atrial Function, Left drug effects
Atrial Remodeling drug effects
Echocardiography, Doppler, Color
Heart Atria diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 16
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24668517
- Full Text :
- https://doi.org/10.1093/europace/euu047