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The ratio of early transmitral flow velocity (E) to early mitral annular velocity (Em) predicts improvement in left ventricular systolic and diastolic function 1 year after catheter ablation for atrial fibrillation

 In-Soo Kim  ;  Tae-Hoon Kim  ;  Chi-Young Shim  ;  Hee-Sun Mun  ;  Jae Sun Uhm  ;  Boyoung Joung  ;  Geu-Ru Hong  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
 EUROPACE, Vol.17(7) : 1051-1058, 2015 
Journal Title
Issue Date
Atrial Fibrillation/complications ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery* ; Blood Flow Velocity ; Catheter Ablation/methods* ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging* ; Mitral Valve/physiopathology ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Stroke Volume ; Treatment Outcome ; Ultrasonography ; Ventricular Dysfunction, Left/diagnostic imaging* ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/surgery*
Atrial fibrillation ; Catheter ablation ; Diastolic function ; Early mitral annular velocity ; Early transmitral flow velocity ; Systolic function
AIMS: Successful rhythm control after atrial fibrillation catheter ablation is known to induce left atrial reverse remodelling and improve left ventricular (LV) function. We explored the clinical factors affecting LV systolic and diastolic function 1-year after catheter ablation for atrial fibrillation. METHODS AND RESULTS: We compared pre-procedural and 1-year follow-up echocardiograms in 521 patients with atrial fibrillation who underwent catheter ablation. Left ventricular systolic function was estimated by the ejection fraction (EF); diastolic function was estimated by the ratio of early transmitral flow velocity (E) to early mitral annular velocity (Em). (i) Catheter ablation of atrial fibrillation significantly reduced left atrium volume index (P < 0.001) and improved LV EF both in patients with recurrent atrial fibrillation (n = 133, P = 0.008) and those without recurrence (n = 388, P < 0.001). (ii) Follow-up EF was significantly improved in patients with baseline E/Em < 15 (n = 454, P < 0.001), whereas E/Em was significantly reduced in patients with pre-procedural E/Em ≥ 15 (n = 67, P = 0.008). (iii) Baseline E/Em < 15 (β = -3.854, 95% CI -5.99 to -1.72, P < 0.001), baseline EF <50% (β = 10.586, 95% CI 7.55 to 13.63, P < 0.001), and female (β = -1.726, 95% CI -3.36 to -0.10, P = 0.038) were independently associated with improved EF. Baseline E/Em ≥ 15 (β = 4.896, 95% CI 3.45 to 6.34, P < 0.001) and younger age (β = -0.066, 95% CI -0.11 to -0.02, P = 0.003) were independent factors associated with improved E/Em. CONCLUSION: Pre-procedural E/Em predicted improvement in LV systolic and diastolic functions 1 year after catheter ablation for atrial fibrillation. Low baseline E/Em was independently associated with improved EF, while high E/Em predicted improvement in LV diastolic function.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Mun, Hee Sun(문희선)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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