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Left ventricular diastolic function is closely associated with mechanical function of the left atrium in patients with paroxysmal atrial fibrillation.

 Jihei Sara Lee  ;  Chi Young Shim  ;  Jin Wi  ;  Boyoung Joung  ;  Jong-Won Ha  ;  Moon Hyoung Lee  ;  Hui-Nam Pak 
 Circulation Journal, Vol.77(3) : 697-704, 2013 
Journal Title
 Circulation Journal 
Issue Date
Background: Left ventricular (LV) diastolic dysfunction may be a mechanism of left atrial (LA) electroanatomical remodeling in atrial fibrillation (AF). We evaluated the association between LV diastolic function and LA mechanical function in non-valvular paroxysmal AF (PAF). Methods and Results: In 286 patients with PAF (males 73%, 57±11 years), LA size, indexed LA volume, LV diastolic function, and LA appendage flow velocity (LAA-FV) in sinus rhythm were measured using transthoracic echocardiography, transesophageal echocardiography and cardiac computed tomography. The LA voltage map was obtained using NavX contact mapping. Patients with impaired LA mechanical function (LAA-FV <58cm/s, n=142) showed a higher E/Em ratio (10.3 vs. 9.2, P=0.034) and lower Em velocity (6.8 vs. 7.7cm/s, P=0.004) than those with preserved function (LAA-FV ≥58cm/s, n=144). The patient population displayed weak correlations of E/Em with LAA-FV (r=-0.19, P=0.003) and LA voltage (r=-0.23, P=0.004), but more significant association of E/Em and LAA-FV (r=-0.39, P<0.001) for age ≥55 years and LA diameter ≥40mm. E/Em was an independent predictor of LAA mechanical function (β=-0.20, P=0.013) even after age, sex, LA size and comorbidities were controlled for. Conclusions: In patients with non-valvular PAF, LA mechanical function is closely related to the degree of LA remodeling and LV diastolic function. Impaired LV diastolic function significantly contributes to LA electoanatomical remodeling in older patients with a larger LA.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박희남(Pak, Hui Nam) ORCID logo https://orcid.org/0000-0002-3256-3620
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
위진(Wi, Jin) ORCID logo https://orcid.org/0000-0003-0655-5130
이문형(Lee, Moon Hyoung) ORCID logo https://orcid.org/0000-0002-7268-0741
정보영(Joung, Bo Young) ORCID logo https://orcid.org/0000-0001-9036-7225
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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