Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation

Abstract Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increas...

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Bibliographic Details
Published in:Journal of cardiology 2016-08, Vol.68 (2), p.104-109
Main Authors: Kim, Tae-Hoon, MD, Shim, Chi Young, MD, PhD, Park, Jae Hyung, PhD, Nam, Chung Mo, PhD, Uhm, Jae-Sun, MD, Joung, Boyoung, MD, PhD, Lee, Moon-Hyoung, MD, PhD, Pak, Hui-Nam, MD, PhD
Format: Article
Language:English
Subjects:
Age Factors
Aged
Atrial Appendage - physiopathology
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Atrial Remodeling
Cardiovascular
Catheter ablation
Catheter Ablation - methods
Echocardiography
Female
Heart Atria - physiopathology
Humans
Ischemic Attack, Transient - etiology
Left ventricular filling pressure
Male
Middle Aged
Risk Factors
Sex Factors
Stroke
Stroke - etiology
Stroke Volume
Tomography, X-Ray Computed
Ventricular Dysfunction, Left - complications
Ventricular Dysfunction, Left - physiopathology
Ventricular Function, Left
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Summary:Abstract Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increased E/Em is related to an advanced LA remodeling, a high CHA2 DS2 -VASc score, and the presence of stroke or transient ischemic attack (TIA) in patients with paroxysmal AF. Methods We included 1098 patients with paroxysmal AF (male 74.5%, 57.6 ± 11.3 years old) who underwent AF catheter ablation. We compared E/Em to clinical parameters, echocardiography, and three-dimensional-computed tomography findings. Results The E/Em > 15 group ( n = 98) was older ( p < 0.001) and had more females ( p < 0.001), greater LA volume index ( p < 0.001), higher CHA2 DS2 -VASc score ( p < 0.001), and stroke/TIA prevalence ( p = 0.001) than groups with an E/Em of 8–15 ( n = 676) or
ISSN:0914-5087
1876-4738
DOI:10.1016/j.jjcc.2015.10.008