Yeonyee E Yoon1, Il-Young Oh1, Sung-Ai Kim2, Kyoung-Ha Park2, Seong Hwan Kim3, Jae-Hyeong Park4, Jeong-Eun Kim5, Seung-Pyo Lee5, Hyung-Kwan Kim5, Yong-Jin Kim5, Dae-Won Sohn5, Goo-Yeong Cho6. 1. Division of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. 2. Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Seoul, Korea. 3. Division of Cardiology, Department of Internal Medicine, Korean University Medical Center, Seoul, Korea. 4. Cardiovascular Division, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea. 5. Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. 6. Division of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. Electronic address: cardioch@snu.ac.kr.
Abstract
BACKGROUNDS: Paroxysmal atrial fibrillation (AF) frequently, but not always, progresses to persistent/permanent AF. The aim of this study was to evaluate the echocardiographic predictors of AF progression in patients with paroxysmal AF. METHODS: A multicenter, prospective, observational study was conducted that included 313 patients with paroxysmal AF who underwent two-dimensional speckle-tracking echocardiography. The diameter, volume, and mechanical function of the left atrium, including global strain (ε) and ε rate, were measured. RESULTS: Progression to persistent or permanent AF occurred in 52 patients (16.6%) during a median follow-up period of 26 months. Echocardiographic measure of left atrial (LA) diameter, volume, and function (E velocity, E/A and E/e' ratio, LA expansion index, active emptying fraction, global longitudinal ε and ε rate) were associated with AF progression. LA ε ≤ 30.9% was the strongest predictor of AF progression, which was associated with a more than fourfold hazard increase for AF progression (hazard ratio, 4.224; P = .001). LA diameter > 39 mm and maximal LA volume index > 34.2 mL/m(2) were associated with about a twofold hazard increase for AF progression (hazard ratios, 1.994 and 2.649; P = .016 and P = .001, respectively). When adjusted for a model combining maximal LA volume index, E velocity, LA expansion index, and active emptying fraction, LA ε ≤ 30.9% maintained a more than threefold hazard increase for AF progression (adjusted hazard ratio, 3.970; P = .003). CONCLUSIONS: Echocardiographic measures of LA diameter, volume, and mechanical function, including LA ε, were associated with AF progression. LA ε was the strongest independent predictor of AF progression and is expected to serve as a valuable predictor of AF progression.
BACKGROUNDS: Paroxysmal atrial fibrillation (AF) frequently, but not always, progresses to persistent/permanent AF. The aim of this study was to evaluate the echocardiographic predictors of AF progression in patients with paroxysmal AF. METHODS: A multicenter, prospective, observational study was conducted that included 313 patients with paroxysmal AF who underwent two-dimensional speckle-tracking echocardiography. The diameter, volume, and mechanical function of the left atrium, including global strain (ε) and ε rate, were measured. RESULTS: Progression to persistent or permanent AF occurred in 52 patients (16.6%) during a median follow-up period of 26 months. Echocardiographic measure of left atrial (LA) diameter, volume, and function (E velocity, E/A and E/e' ratio, LA expansion index, active emptying fraction, global longitudinal ε and ε rate) were associated with AF progression. LA ε ≤ 30.9% was the strongest predictor of AF progression, which was associated with a more than fourfold hazard increase for AF progression (hazard ratio, 4.224; P = .001). LA diameter > 39 mm and maximal LA volume index > 34.2 mL/m(2) were associated with about a twofold hazard increase for AF progression (hazard ratios, 1.994 and 2.649; P = .016 and P = .001, respectively). When adjusted for a model combining maximal LA volume index, E velocity, LA expansion index, and active emptying fraction, LA ε ≤ 30.9% maintained a more than threefold hazard increase for AF progression (adjusted hazard ratio, 3.970; P = .003). CONCLUSIONS: Echocardiographic measures of LA diameter, volume, and mechanical function, including LA ε, were associated with AF progression. LA ε was the strongest independent predictor of AF progression and is expected to serve as a valuable predictor of AF progression.
Authors: John Whitaker; Ronak Rajani; Henry Chubb; Mark Gabrawi; Marta Varela; Matthew Wright; Steven Niederer; Mark D O'Neill Journal: Europace Date: 2016-05-31 Impact factor: 5.214
Authors: Juan Lacalzada-Almeida; María Manuela Izquierdo-Gómez; Javier García-Niebla; Roberto Elosua; Alejandro Jiménez-Sosa; Adrian Baranchuk; Antonio Bayes de Luna Journal: Ann Noninvasive Electrocardiol Date: 2019-02-05 Impact factor: 1.468
Authors: Francesco De Sensi; Diego Penela; David Soto-Iglesias; Antonio Berruezo; Ugo Limbruno Journal: J Clin Med Date: 2021-05-24 Impact factor: 4.241