Left Atrial Mechanical Function and Aortic Stiffness in Middle-aged Patients with the First Episode of Atrial Fibrillation

• Published in: Chinese medical journal 2017-01, Vol.130 (2), p.143-148
• Main Authors: Kilicgedik, Alev, Efe, Suleyman Ç, Gürbüz, Ahmet, Acar, Emrah, Yılmaz, Mehmet, Erdoğan, Aslan, Kahveci, GöKhan, Izgi, Ibrahim, Kirma, Cevat
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Aortic Stiffness; Atrial Fibrillation; Atrial Strain; Atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Function, Left - physiology; Atrial Remodeling - physiology; Blood pressure; Cardiac arrhythmia; Cardiology; Cardiovascular disease; Care and treatment; Echocardiography; Female; Health aspects; Heart; Heart atrium; Hospitals; Humans; Hypertension; Male; Middle age; Middle Aged; Middle aged persons; NMR; Nuclear magnetic resonance; Original; Prospective Studies; Vascular Stiffness - physiology; Velocity; 一次测量; 主动脉; 心房; 患者; 机械功能; 硬度; 超声心动图; 颤动
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.197979

Background： In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial （LA） mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with tile first episode of nonvalvular atrial fibrillation （AF）. Methods： This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Kos.;uyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1^st month （mostly in the first 2 weeks） following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results： Pulse wave analysis showed no significant differences between tile AF patients and healthy controls with respect to PWV （ 10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s： P = 0.370）, augmentation pressure （9.6 ± 7.4 mmHg vs. 9. 1± 5.7 mmHg; P = 0.740）, and aortic pulse pressure （AoPP; 40.4 ± 14.0 mmHg vs. 42. 1 ±7.6 mmHg, P = 0.550）. The first LA positive peak of strain was inversely related to the augmentation pressure （r 0.30; P = 0.02） and aortic systolic pressure （r - 0.26, P - 0.04）. Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement （45.1± 14.1 mmHg） showed a significant increase compared with AoPP at the first measurement （39.0 ±10.6 mmHg, P = 0.028）, which was also higher than that of healthy controls （42.1 ± 7.6 mmHg, P = 0.000）. Conclusion： The association between aortic stiffness with reduced atrial strain anti the key role of AoPP in the development olAF should be considered when treating nonvalvular AF patients with normal LA sizes.