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Left Atrial Function Assessed by Doppler Echocardiography Rather Than Left Atrial Volume Predicts Recurrence in Patients With Paroxysmal Atrial Fibrillation

Authors
 Ji Hyun Yoon  ;  Jeonggeun Moon  ;  Se-Joong Rim  ;  Hyuck-moon Kwon  ;  Bum-kee Hong  ;  Byoung-kwon Lee  ;  Young-won Yoon  ;  Pil-ki Min  ;  Jong-Youn Kim  ;  Eui-Young Choi  ;  Hye moon Chung 
Citation
 Clinical Cardiology, Vol.36(4) : 235-240, 2013 
Journal Title
 Clinical Cardiology 
ISSN
 0160-9289 
Issue Date
2013
Abstract
BACKGROUND: Paroxysmal atrial fibrillation (PaAF) may present as a single self-terminating episode of atrial fibrillation (AF) or a more persistent form after sinus conversion. We investigated predictors of recurrence in patients with PaAF. HYPOTHESIS: Left atrial function would be an useful parameter for predicting PaAF recurrence. METHODS: The study population included 228 PaAF patients (131 males, age 64±14 years) who underwent transthoracic echocardiography immediately after spontaneous sinus conversion at initial AF diagnosis. We followed the study patients for AF recurrence. RESULTS: AF recurrence was demonstrated in 45 patients (20%, age 68±13 years) after spontaneous sinus conversion. Patients with recurrence had larger left atrial volume index (32±12 vs 25±10 mL/m2, P<0.001), left ventricle mass index (107±34 vs 93±25 g/m2, P=0.012), and left ventricle filling pressure (E/e'') (14±7 vs 12±5, P=0.012), whereas early diastolic mitral annular velocity (e') (5±2 vs 6±3 cm/s, P=0.021), late diastolic mitral annular velocity (A') (7±3 vs 9±2 cm/s, P<0.001), and peak systolic mitral annular velocity (7±2 vs 8±2 cm/s, P=0.045) were significantly lower. In multivariate Cox regression analysis detecting independent predictors of PaAF recurrence, lower A' (hazard ratio: 0.623, 95% confidence interval: 0.476-0.815, P=0.001) was a significant predictor of AF recurrence. CONCLUSIONS: A', which indicates left atrial (LA) contractile function after sinus conversion, was the independent predictor of PaAF recurrence, whereas LA volume was not. LA function may be more important than LA volume in predicting recurrence particularly in patients with PaAF.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86623
DOI
10.1002/clc.22105
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
권혁문(Kwon, Hyuck Moon) ; 김종윤(Kim, Jong Youn) ; 문정근(Moon, Jeong Geun) ; 민필기(Min, Pil Ki) ; 윤영원(Yoon, Young Won) ; 윤지현(Yoon, Ji Hyun) ; 이병권(Lee, Byoung Kwon) ; 임세중(Rim, Se Joong) ; 정혜문(Chung, Hye Moon) ; 최의영(Choi, Eui Young) ; 홍범기(Hong, Bum Kee)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1002/clc.22105/abstract
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