Background and Objectives: The evaluation of left ventricular (LV) diastolic function in patients with atrial fibrillation (AF) is challenging. This study aimed to investigate the efficacy of the diagnostic algorithm for LV diastolic dysfunction (LVDD) in the current guidelines and to evaluate the association between increased left atrial pressure (LAP) and LV diastolic parameters. Methods: One hundred and twenty-four patients with non-valvular AF and a preserved LV ejection fraction who had the same rhythm status on echocardiography and LAP measurements during catheter ablation were included. LV diastolic function was classified as normal, indeterminate, or LVDD according to the recent guidelines. Increased LAP was defined as mean LAP (mLAP) ≥15 mmHg. Results: The mLAP was not different among the normal, indeterminate, and LVDD groups. However, the prevalence of increased LAP was higher in the LVDD group. Among the LV diastolic parameters, only medial E/e' was independently associated with mLAP in the whole study population. In patients with persistent AF (PeAF), E/e' and e' were significantly associated with mLAP, whereas in paroxysmal AF (PAF), mLAP was not associated with the LV diastolic parameters but with left atrial conduit function. Conclusions: In general, increased LAP is known to be closely related with LVDD. However, the algorithm for LVDD from recent guidelines does not reflect well the increased LAP in AF patients. The diastolic parameters may aid in estimating the increased LAP in PeAF but may only have limited value for assessing increased LAP in PAF.
Background and Objectives: The evaluation of left ventricular (LV) diastolic function in patients with atrial fibrillation (AF) is challenging. This study aimed to investigate the efficacy of the diagnostic algorithm for LV diastolic dysfunction (LVDD) in the current guidelines and to evaluate the association between increased left atrial pressure (LAP) and LV diastolic parameters. Methods: One hundred and twenty-four patients with non-valvular AF and a preserved LV ejection fraction who had the same rhythm status on echocardiography and LAP measurements during catheter ablation were included. LV diastolic function was classified as normal, indeterminate, or LVDD according to the recent guidelines. Increased LAP was defined as mean LAP (mLAP) ≥15 mmHg. Results: The mLAP was not different among the normal, indeterminate, and LVDD groups. However, the prevalence of increased LAP was higher in the LVDD group. Among the LV diastolic parameters, only medial E/e' was independently associated with mLAP in the whole study population. In patients with persistent AF (PeAF), E/e' and e' were significantly associated with mLAP, whereas in paroxysmal AF (PAF), mLAP was not associated with the LV diastolic parameters but with left atrial conduit function. Conclusions: In general, increased LAP is known to be closely related with LVDD. However, the algorithm for LVDD from recent guidelines does not reflect well the increased LAP in AF patients. The diastolic parameters may aid in estimating the increased LAP in PeAF but may only have limited value for assessing increased LAP in PAF.
Authors: Roberto M Lang; Luigi P Badano; Victor Mor-Avi; Jonathan Afilalo; Anderson Armstrong; Laura Ernande; Frank A Flachskampf; Elyse Foster; Steven A Goldstein; Tatiana Kuznetsova; Patrizio Lancellotti; Denisa Muraru; Michael H Picard; Ernst R Rietzschel; Lawrence Rudski; Kirk T Spencer; Wendy Tsang; Jens-Uwe Voigt Journal: J Am Soc Echocardiogr Date: 2015-01 Impact factor: 5.251
Authors: Kimi Sato; Andrew D M Grant; Kazuaki Negishi; Paul C Cremer; Tomoko Negishi; Arnav Kumar; Patrick Collier; Samir R Kapadia; Richard A Grimm; Milind Y Desai; Brian P Griffin; Zoran B Popović Journal: Am Heart J Date: 2017-04-04 Impact factor: 4.749
Authors: Michael G Dickinson; Carolyn S Lam; Michiel Rienstra; Ton E Vonck; Yoran M Hummel; Adriaan A Voors; Elke S Hoendermis Journal: Eur J Heart Fail Date: 2017-09-25 Impact factor: 15.534
Authors: Mohammadali Habibi; Joao A C Lima; Irfan M Khurram; Stefan L Zimmerman; Vadim Zipunnikov; Kotaro Fukumoto; David Spragg; Hiroshi Ashikaga; John Rickard; Joseph E Marine; Hugh Calkins; Saman Nazarian Journal: Circ Cardiovasc Imaging Date: 2015-02 Impact factor: 7.792
Authors: Anna Degiovanni; Enrico Boggio; Eleonora Prenna; Chiara Sartori; Federica De Vecchi; Paolo N Marino Journal: Clin Res Cardiol Date: 2017-11-27 Impact factor: 5.460