Left Atrial Mechanical Function and Stiffness in Patients with Paroxysmal Atrial Fibrillation
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Abnormalities in the left atrial (LA) structure and function may develop in patients with paroxysmal atrial fibrillation (AF). We sought to determine the contribution of LA mechanical function, including LA stiffness, to AF by comparing patients with paroxysmal AF with normal control subjects, and to evaluate whether LA mechanical function and stiffness are related with the structural changes of LA. Methods: Sixty-four paroxysmal AF patients (57 ± 13 years, 59% male) were studied, using a speckle tracking echocardiography,and were compared with 34 age-, gender-, and left ventricular (LV) mass-matched controls (53 ± 14 years, 61% male). LA volume indices, expansion index for reservoir function, active emptying fraction for contractile function, mitral annular velocities,and global longitudinal LA strain were measured. The ratio of E/e’ to LA strain was used as an index of LA stiffness. Results: Patients with paroxysmal AF had similar LV volume indices, ejection fraction, and diastolic function, when compared with that of the normal controls. However, paroxysmal AF patients showed increased LA volume indices and decreased LA reservoir function, but similar contractile function. LA stiffness was increased in patients with paroxysmal AF than in the control subjects (0.40 ± 0.25 vs. 0.29 ± 0.10, p = 0.002), and was related with LA volume indices and reservoir function. Conclusion: Patients with paroxysmal AF have decreased LA reservoir function and increased stiffness, in comparison with that of the control subjects. LA stiffness was significantly related with LA volume indices and reservoir function. LA stiffness can be used for the assessment of LA function in patients with paroxysmal AF.
Abstract
Background: Abnormalities in the left atrial (LA) structure and function may develop in patients with paroxysmal atrial fibrillation (AF). We sought to determine the contribution of LA mechanical function, including LA stiffness, to AF by comparing patients with paroxysmal AF with normal control subjects, and to evaluate whether LA mechanical function and stiffness are related with the structural changes of LA. Methods: Sixty-four paroxysmal AF patients (57 ± 13 years, 59% male) were studied, using a speckle tracking echocardiography,and were compared with 34 age-, gender-, and left ventricular (LV) mass-matched controls (53 ± 14 years, 61% male). LA volume indices, expansion index for reservoir function, active emptying fraction for contractile function, mitral annular velocities,and global longitudinal LA strain were measured. The ratio of E/e’ to LA strain was used as an index of LA stiffness. Results: Patients with paroxysmal AF had similar LV volume indices, ejection fraction, and diastolic function, when compared with that of the normal controls. However, paroxysmal AF patients showed increased LA volume indices and decreased LA reservoir function, but similar contractile function. LA stiffness was increased in patients with paroxysmal AF than in the control subjects (0.40 ± 0.25 vs. 0.29 ± 0.10, p = 0.002), and was related with LA volume indices and reservoir function. Conclusion: Patients with paroxysmal AF have decreased LA reservoir function and increased stiffness, in comparison with that of the control subjects. LA stiffness was significantly related with LA volume indices and reservoir function. LA stiffness can be used for the assessment of LA function in patients with paroxysmal AF.
참고문헌 (17)
- Vidaillet H, "A population-based study of mortality among patients with atrial fibrillation or flutter", Am J Med, 113, pp.365~370 (2002)
- Stewart S, "A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew", Paisley study, 2002, pp.113, 359~364
- Kuppahally SS, "Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI", Circ Cardiovasc Imaging, 3, pp.231~239 (2010)
- Dittrich HC, "Left atrial diameter in nonvalvular atrial fibrillation: an echocardiographic study. Stroke Prevention in Atrial Fibrillation Investigators", Am Heart J, 137, pp.494~499 (1999)
- Parkash R, "Canadian Registry of Atrial Fibrillation. The association of left atrial size and occurrence of atrial fibrillation: a prospective cohort study from the Canadian Registry of Atrial Fibrillation", Am Heart J, 148, pp.649~654 (2004)
- Sitges M, "Is there an anatomical substrate for idiopathic paroxysmal atrial fibrillation? A case-control echocardiographic study", Europace, 9, pp.294~298 (2007)
- Kurt M, "Left atrial function in diastolic heart failure", Circ Cardiovasc Imaging, 2, pp.10~15 (2009)
- Machino-Ohtsuka T, "Left atrial stiffness relates to left ventricular diastolic dysfunction and recurrence after pulmonary vein isolation for atrial fibrillation", J Cardiovasc Electrophysiol, 22, pp.999~1006 (2011)
- Cheitlin MD, "ACC", AHA Guidelines for the Clinical Application of Echocardiography. A report of the American College of Cardiology, Circulation, pp.1997, 95[DOI]
- Lang RM, "Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology", J Am Soc Echocardiogr, 18, pp.1440~1463 (2005)
- Quiñnones MA, "Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography", J Am Soc Echocardiogr, 15, pp.167~184 (2002)
- Triposkiadis F, "Echocardiographic assessment of left atrial ejection force and kinetic energy in chronic heart failure", Int J Cardiovasc Imaging, 24, pp.15~22 (2008)
- D’Andrea A, "Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy: a two-dimensional speckle strain study", Eur Heart J, 28, pp.2738~2748 (2007)
- Hwang HJ, "Left atrial strain as predictor of successful outcomes in catheter ablation for atrial fibrillation: a two-dimensional myocardial imaging study", Journal Of Interventional Cardiac Electrophysiology, 26(2), pp.127~132 (2009)
- Abhayaratna WP, "Left atrial reservoir function as a potent marker for first atrial fibrillation or flutter in persons > or = 65 years of age", Am J Cardiol, 101, pp.1626~1629 (2008)
- Di Salvo G, "Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study", Circulation, 112, pp.387~395 (2005)
- Henein M, "Disturbed left atrial mechanical function in paroxysmal atrial fibrillation: a speckle tracking study", Int J Cardiol, 155, pp.437~441 (2012)