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

Authors
 Tae-Hoon Kim  ;  Chi Young Shim  ;  Jae Hyung Park  ;  Chung Mo Nam  ;  Jae-Sun Uhm  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
Citation
 JOURNAL OF CARDIOLOGY, Vol.68(2) : 104-109, 2016 
Journal Title
 JOURNAL OF CARDIOLOGY 
ISSN
 0914-5087 
Issue Date
2016
MeSH
Age Factors ; Aged ; Atrial Appendage/physiopathology ; Atrial Fibrillation/complications* ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Atrial Remodeling* ; Catheter Ablation/methods ; Echocardiography ; Female ; Heart Atria/physiopathology ; Humans ; Ischemic Attack, Transient/etiology* ; Male ; Middle Aged ; Risk Factors ; Sex Factors ; Stroke/etiology* ; Stroke Volume ; Tomography, X-Ray Computed ; Ventricular Dysfunction, Left/complications* ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left
Keywords
Atrial fibrillation ; Catheter ablation ; Left ventricular filling pressure ; Stroke
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 CHA2DS2-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 CHA2DS2-VASc score (p<0.001), and stroke/TIA prevalence (p=0.001) than groups with an E/Em of 8-15 (n=676) or <8 (n=324). An E/Em was independently associated with the presence of stroke/TIA (OR 1.638, 95% CI 1.050-2.554, p=0.030) after adjusting for age, sex, body surface area, LA volume index, and LA appendage volume index. CONCLUSIONS: In patients with paroxysmal AF, the elevated LV filling pressure estimated by E/Em is independently associated with the presence of stroke or TIA.
Files in This Item:
T201602114.pdf Download
DOI
10.1016/j.jjcc.2015.10.008
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165108
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