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Echo-Doppler-derived indexes of ventricular stiffness and ventriculo-arterial interaction as predictors of new-onset atrial fibrillation in patients with heart failure

 Ji Hyun Yoon  ;  Myung-Hyun Kim  ;  Hyemoon Chung  ;  Eui-Young Choi  ;  Pil-Ki Min  ;  Young Won Yoon  ;  Byoung Kwon Lee  ;  Bum-Kee Hong  ;  Se-Joong Rim  ;  Hyuck Moon Kwon  ;  Jong-Youn Kim 
 Cardiovascular Ultrasound, Vol.14(1) : 1-7, 2016 
Journal Title
 Cardiovascular Ultrasound 
Issue Date
Aged ; Atrial Fibrillation/diagnostic imaging* ; Atrial Fibrillation/mortality* ; Atrial Fibrillation/physiopathology ; Causality ; Comorbidity ; Echocardiography, Doppler/statistics & numerical data* ; Elastic Modulus ; Elasticity Imaging Techniques/statistics & numerical data ; Female ; Heart Failure/diagnostic imaging* ; Heart Failure/mortality* ; Heart Failure/physiopathology ; Humans ; Image Interpretation, Computer-Assisted/methods ; Male ; Middle Aged ; Prevalence ; Prognosis ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/methods ; Sensitivity and Specificity ; Stroke Volume ; Survival Rate ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/mortality* ; Ventricular Dysfunction, Left/physiopathology
Left ventricular stiffness ; Atrial fibrillation ; Heart failure ; Diastolic dysfunction
BACKGROUND: Atrial fibrillation (AF) is common in patients with heart failure (HF) and worsens their prognosis. Vulnerability to changes in loading is an important factor in the development of AF and is strongly influenced by ventricular stiffness and ventriculo-arterial interaction. The aim of this study was to investigate predictors of AF development in patients with HF. METHODS: We studied 349 patients with stable HF. The following parameters of ventricular stiffness and ventriculo-arterial interaction were derived from echo-Doppler measurements: left ventricular (LV) diastolic elastance (Ed), effective arterial elastance (Ea), LV end-systolic elastance (Ees) and ventricular-vascular coupling index (VVI). RESULTS: AF occurred in 57 (16.3%) patients over a median follow up of 30.3 months. Echo-Doppler-derived parameters of ventricular stiffness and ventriculo-arterial interaction were closely associated with HF severity. Ed was independently associated with AF after adjustment for age, hypertension, diabetes mellitus, and left atrial volume index (hazard ratio [HR] 5.49, p = 0.018). Ea and VVI were also associated with new-onset AF (HR 1.66, p = 0.027, and HR 1.06, p = 0.001, respectively). CONCLUSIONS: Echo-Doppler indexes of ventricular stiffness are closely associated with HF severity. LV diastolic elastance (Ed) is the strongest predictor of new-onset AF in HF patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
권혁문(Kwon, Hyuck Moon) ORCID logo https://orcid.org/0000-0001-9901-5015
김종윤(Kim, Jong Youn) ORCID logo https://orcid.org/0000-0001-7040-8771
민필기(Min, Pil Ki) ORCID logo https://orcid.org/0000-0001-7033-7651
윤영원(Yoon, Young Won) ORCID logo https://orcid.org/0000-0002-0907-0350
윤지현(Yoon, Ji Hyun)
이병권(Lee, Byoung Kwon) ORCID logo https://orcid.org/0000-0001-9259-2776
임세중(Rim, Se Joong) ORCID logo https://orcid.org/0000-0002-7631-5581
최의영(Choi, Eui Young) ORCID logo https://orcid.org/0000-0003-3732-0190
홍범기(Hong, Bum Kee) ORCID logo https://orcid.org/0000-0002-6456-0184
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