Atrial Activation Time Determined by Transthoracic Doppler Tissue Imaging Can Be Used as an Estimate of the Total Duration of Atrial Electrical Activation

Merckx, K; Vos, Cees B. de; Palmans, Andrea; Habets, Jos; Cheriex, Emile C.; Crijns, Harry J.G.M.; Tieleman, Robert G

doi:10.1016/j.echo.2005.03.022

Cited by 111 publications

(144 citation statements)

References 19 publications

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“…There was no statistically significant difference in intra-right atrial and interatrial conduction times between the groups, and only ILCT was detected as an independent marker of paroxysmal AF in that study [14]. Merckx et al [15] demonstrated that tissue Doppler echocardiography can be used to measure total duration of atrial electrical activation which is valuable to detect patients with risk of AF development. In another study, left atrial electromechanical conduction time was found to be significantly prolonged in patients with recurring AF after electrical cardioversion, and it has been stated that electromechanical conduction time parameters evaluated by tissue Doppler echocardiography can be used as indicators of atrial conduction time for prediction of sinus rhythm maintenance [16].…”

Section: Discussionmentioning

confidence: 80%

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Deniz

Şahiner²,

Aytemir³

et al. 2012

Cardiol J

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Section: Discussionmentioning

confidence: 80%

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Deniz

Şahiner²,

Aytemir³

et al. 2012

Cardiol J

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“…9,33 Despite the intriguing findings of this study, certain limitations should be stressed. A recent study 34 proposed that a single-tissue Doppler imaging test might not be sufficient to characterize intraventricular dyssynchrony, and therefore may also be insufficient to determine intra-and interatrial synchronicity in one test.…”

Section: Discussionmentioning

confidence: 80%

Impaired atrial synchronicity in patients with metabolic syndrome associated with insulin resistance and independent of hypertension

Yang

Gong

et al. 2009

Hypertens Res

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The risk of developing atrial fibrillation is increased in patients with metabolic syndrome, but atrial conduction properties are uncharacterized in patients who have metabolic syndrome without atrial arrhythmia. We used tissue Doppler imaging to evaluate intra-and interatrial synchronicity in such patients. The imaging was performed in 145 patients with metabolic syndrome and 110 controls. Atrial synchronicity was determined from the intervals between the onset of the P-wave to the onset of the A-wave at the left atrial free wall (P-LA), interatrial septum (P-IAS) and right atrial free wall (P-RA). Intra-atrial synchronicity was defined as the differences between P-IAS and P-RA (RA synchronicity) and between P-LA and P-IAS (LA synchronicity). Interatrial synchronicity was defined as the difference between P-LA and P-RA. P-LA and P-IAS were significantly prolonged in the metabolic syndrome group relative to the control group (P-LA: 64.34 ± 13.99 vs. 55.35 ± 12.67, Po0.001; P-IAS: 36.49±12.39 vs. 31.55±11.61, P¼0.001), whereas P-RA showed no difference. As a result, this caused impaired intra-and interatrial synchronicity in patients with metabolic syndrome. Stepwise multivariate linear analysis revealed insulin resistance as an independent predictor of impaired intra-and interatrial synchronicity. Subgroup analysis indicated that there was no difference in atrial asynchrony between non-hypertensive and hypertensive subgroups in metabolic syndrome patients. In conclusion, patients with metabolic syndrome without atrial arrhythmia have impaired intra-and interatrial synchronicity. Insulin resistance has an important role in impaired atrial conduction in these patients.

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“…Fourth, in previous reports, total atrial conduction time has been assessed using TDI by measuring the time interval between the onset of the P-wave and peak of a' wave of the lateral atrial wall. 38,39) However, our study lacks data on the TDI of the lateral wall. Finally, although recent episodes of atrial fibrillation may cause subsequent atrial stunning potentially influencing echocardiographic data, we lack information on the duration from the latest AF events.…”

Section: Discussionmentioning

confidence: 95%

Left Atrial Remodeling Assessed by Transthoracic Echocardiography Predicts Left Atrial Appendage Flow Velocity in Patients With Paroxysmal Atrial Fibrillation

et al. 2016

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SummaryAtrial fibrillation (AF) is associated with an increased risk of stroke and other thromboembolic events. Left atrial (LA) thrombus formation is closely related to LA dysfunction, particularly to decreased LA appendage flow velocity (LAA-FV) in patients with AF. We estimated LAA-FV using parameters noninvasively obtained by transthoracic echocardiography (TTE) in patients with paroxysmal AF.Echocardiographic and clinical parameters were assessed in 190 patients with nonvalvular paroxysmal AF showing sinus heart rhythm during transesophageal echocardiography (TEE) and TTE.LAA-FV (60 ± 22 cm/s) significantly correlated with the time interval between the initiation of the P-wave on ECG and that of the A-wave of transmitral flow on TTE (PA-TMF, correlation coefficient, −0.32; P < 0.001), LA dimension (LAD, −0.31; P < 0.001), septal a' velocity of tissue Doppler imaging (TDI, 0.35; P < 0.001), E/e' ratio (−0.28, P < 0.001), E velocity of transmitral flow (−0.20, P = 0.008), E/A ratio of transmitral flow (−0.18, P = 0.02), CHA2DS2-VASc score (−0.15, P = 0.04), and BNP plasma level (−0.32, P = 0.002). Multivariate analysis revealed that PA-TMF (standardized partial regression coefficient, −0.17; P = 0.03), a' velocity (0.24, P = 0.004), and LAD (−0.20, P = 0.01) were independent predictors of LAA-FV (multiple correlation coefficient R, 0.44; P < 0.001).Parameters of atrial remodeling, ie, decreased a' velocity, increased LAD, and PA-TMF during sinus rhythm may be useful predictors of LA blood stasis in patients with nonvalvular PAF. LAA-FV can be estimated using these TTE parameters instead of TEE. (Int Heart J 2016; 57: 177-182)

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Atrial Activation Time Determined by Transthoracic Doppler Tissue Imaging Can Be Used as an Estimate of the Total Duration of Atrial Electrical Activation

Cited by 111 publications

References 19 publications

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time

Impaired atrial synchronicity in patients with metabolic syndrome associated with insulin resistance and independent of hypertension

Left Atrial Remodeling Assessed by Transthoracic Echocardiography Predicts Left Atrial Appendage Flow Velocity in Patients With Paroxysmal Atrial Fibrillation

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