Association of Left Atrial Function and Left Atrial Enhancement in Patients With Atrial Fibrillation

Habibi, Mehdi; Lima, João A.C.; Khurram, Irfan M.; Zimmerman, Stefan L.; Zipunnikov, Vadim; Fukumoto, Kotaro; Spragg, David D.; Ashikaga, Hiroshi; Rickard, John; Marine, Joseph E.; Calkins, Hugh; Nazarian, Saman

doi:10.1161/circimaging.114.002769

Cited by 161 publications

(128 citation statements)

References 35 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…In fact, Habibi et al found that hypertensive patients with LA enhancement were more inclined to persistent or permanent atrial fibrillation. 29 Therefore, our study adds to the current knowledge by providing new functional issues in patients with similar LV hypertrophy, but different pathophysiology, in an attempt to improve the therapeutic approach to these difficult conditions.…”

Section: Discussionmentioning

confidence: 91%

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –

Gregorio

Dattilo

Casale

et al. 2016

Circ J

View full text Add to dashboard Cite

Background:We sought to assess left atrial (LA) morphology and function in patients with transthyretin cardiac amyloidosis (TTR-CA) and hypertrophic cardiomyopathy (HCM). Primarily, longitudinal deformation (reservoir) and pump function were the focus of vector-velocity strain echocardiography imaging. Methods and Results:The study group comprised 32 patients (mean age 57.7±15.4 years, 16 in each group), and 15 healthy controls. Diagnosis of TTR-CA was based on echocardiography and either gadolinium-enhanced (LGE) cardiac magnetic resonance (cMRI) or radionuclide imaging. At baseline, there were no differences in age, body surface area, blood pressure and risk factors among the groups. Left ventricular (LV) mass was greater in patients than in controls, and slight LA dilatation was found in the TTR-CA group. LA reservoir was 14.1±4.7% in TTR-CA, 20.0±5.6% in HCM, and 34.0±11.8% in controls (<0.001). In addition, LA pump function chiefly was impaired in the former group, irrespective of LA chamber size and LV ejection fraction. LGE in the atrial wall was seen in 9/10 TTR-CA versus 0/8 HCM patients undergoing cMRI (P<0.001). LA reservoir ≤19% and pump function ≤-1.1% best discriminated TTR-CA from HCM patients in the receiver-operating characteristic analysis. Conclusions:LA reservoir and pump function were significantly impaired in both TTR-CA and HCM patients compared with controls, but mainly in the former group, irrespective of LA volume and LV ejection fraction, likely caused by a more altered LA wall structure. (Circ J 2016; 80: 1830 -1837

show abstract

Section: Discussionmentioning

confidence: 91%

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –

Gregorio

Dattilo

Casale

et al. 2016

Circ J

View full text Add to dashboard Cite

show abstract

“…14,15 Moreover, increased atrial fibrosis contributes to atrial enlargement and functional impairment. 16 Although evidence is scarce, intrinsic atrial myopathy as part of the molecular disease has been suggested as well. 5 Specific sarcomeric gene mutations have recently been described in atypical forms of HCM that relate to juvenile onset of AF in these patients.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Size and Function in Hypertrophic Cardiomyopathy Patients and Risk of New-Onset Atrial Fibrillation

Debonnaire

Joyce

Hiemstra

et al. 2017

Circ: Arrhythmia and Electrophysiology

138

View full text Add to dashboard Cite

Background— The value of left atrial (LA) diameter, volume, and strain to risk stratify hypertrophic cardiomyopathy patients for new-onset atrial fibrillation (AF) was explored. Methods and Results— A total of 242 hypertrophic cardiomyopathy patients without AF history were evaluated by (speckle-tracking) echocardiography. During mean follow-up of 4.8±3.7 years, 41 patients (17%) developed new-onset AF. Multivariable analysis showed LA volume (≥37 mL/m 2 ; hazard ratio, 2.68; 95% confidence interval, 1.30–5.54; P =0.008) and LA strain (≤23.4%; hazard ratio, 3.22; 95% confidence interval, 1.50–6.88; P =0.003), but not LA diameter (≥45 mm; hazard ratio, 1.67; 95% confidence interval, 0.84–3.32; P =0.145), as independent AF correlates. Importantly, 59% (n=24) of AF events occurred despite a baseline LA diameter <45 mm, observed in 185 patients. In this patient subset, LA strain (area under the curve 0.73) and LA volume (area under the curve 0.83) showed good predictive value for new-onset AF. Furthermore, patients with LA volume <37 versus ≥37 mL/m 2 and LA strain >23.4% versus ≤23.4% had superior 5-year AF-free survival of 93% versus 80% ( P =0.003) and 98% versus 74% ( P =0.002), respectively. Importantly, LA volume <37 mL/m 2 and strain >23.4% yielded high negative predictive value (93% and 98%, respectively) for new-onset AF. Likelihood ratio test indicated incremental value of LA volume assessment ( P =0.011) on top of LA diameter to predict new-onset AF in hypertrophic cardiomyopathy patients with LA diameter <45 mm, which tended to increase further by addition of LA strain ( P =0.126). Conclusions— LA diameter, volume, and strain all relate to new-onset AF in hypertrophic cardiomyopathy patients. In patients with normal LA size, however, both LA volume and strain further refine risk stratification for new-onset AF.

show abstract

“…However, the recent development of a CMR technique that tracks LA wall motion using cine CMR imaging has shown promise as a good alternative for LA function assessment. 40 Further validation specifically in patients with AF is necessary.…”

Section: La Functionmentioning

confidence: 99%

Atrial Fibrillation Pathophysiology and Prognosis

Siontis

Gersh

2015

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

show abstract

Association of Left Atrial Function and Left Atrial Enhancement in Patients With Atrial Fibrillation

Cited by 161 publications

References 35 publications

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –

Left Atrial Size and Function in Hypertrophic Cardiomyopathy Patients and Risk of New-Onset Atrial Fibrillation

Atrial Fibrillation Pathophysiology and Prognosis

Contact Info

Product

Resources

About

Association of Left Atrial Function and Left Atrial Enhancement in Patients With Atrial Fibrillation

Cited by 161 publications

References 35 publications

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy – Comparative Strain Imaging Study –

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy – Comparative Strain Imaging Study –

Left Atrial Size and Function in Hypertrophic Cardiomyopathy Patients and Risk of New-Onset Atrial Fibrillation

Atrial Fibrillation Pathophysiology and Prognosis

Contact Info

Product

Resources

About

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –

Left Atrial Morphology, Size and Function in Patients With Transthyretin Cardiac Amyloidosis and Primary Hypertrophic Cardiomyopathy　– Comparative Strain Imaging Study –