Atrial Electromechanical Interval May Predict Cardioembolic Stroke in Apparently Low Risk Elderly Patients with Paroxysmal Atrial Fibrillation

Hoshi, Makoto; Nozawa, Yukinaga; Ogasawara, M.; Yuda, Satoshi; Sato, Motoki; Sakasai, M T Takuya; Oka, Machiko; Katayama, Minako; Sato, Miho; Kouzu, Hidemichi; Nishihara, Masahiro; Doi, Atsushi; Nishimiya, Takatoshi; Miura, Tetsuji

doi:10.1111/echo.12329

Cited by 14 publications

(15 citation statements)

References 33 publications

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“…in their study detected that lengthened PA‐PDI time may be an independent predictor of stroke and could increase the predictive power of CHA2DS2‐VASc score to predict the risk of stroke when combined with CHA2DS2‐VASc score. Hoshi et al . demonstrated a significantly lengthened AEMD times in patients with high CHA2DS2‐VASc scores in their study and they detected lengthened AEMD times in patients with a history of cardioembolic stroke compared to the patients with no such history.…”

Section: Discussionmentioning

confidence: 77%

The Relationships between Atrial Electromechanical Delay and CHA2DS2‐VASc Score in Patients Diagnosed with Paroxysmal AF

et al. 2014

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Section: Discussionmentioning

confidence: 77%

The Relationships between Atrial Electromechanical Delay and CHA2DS2‐VASc Score in Patients Diagnosed with Paroxysmal AF

et al. 2014

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“…Hoshi et al (27) stated that patients with PAF had a larger left atrial volume index and longer interatrial EMD compared with the normal population. When patients with PAF were reassessed according to their history of cardioembolic stroke, age and interatrial EMD were found to be independently related to cardioembolic stroke; however, no association was demonstrated between the left atrial volume index and history of cardioembolic stroke.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation

et al. 2015

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Objective:This study aimed to evaluate the association between the history of stroke/transient ischemic attack (TIA) and inter- and intra-atrial electromechanical delay (EMD) in patients with paroxysmal atrial fibrillation (PAF).Methods:Patients diagnosed with PAF were included in this retrospective study. Patients who had a history of stroke or TIA were defined as the symptomatic group, whereas those who did not have such a history were defined as the asymptomatic group. On the basis of the transthoracic echocardiographic records, atrial electromechanical coupling (time interval from the onset of the P wave on the surface electrocardiogram to the beginning of the A’ wave interval with tissue Doppler echocardiography) and intra- and interatrial EMD were measured.Results:In this study, 160 patients were included, 52 of whom were symptomatic. While the intra-left atrial EMD was 68.2±6.1 ms in the symptomatic group, it was found to be 50.8±6.5 ms in the asymptomatic group (p<0.001). Interatrial EMD was 91.3±5.0 ms in the symptomatic group, whereas it was 71.5±7.0 ms in the asymptomatic group (p<0.001). In multiple logistic regression analysis, intra-left atrial [odds ratio (OR): 1.417, 95% confidence interval (CI): 1.193–1.684, p<0.001] and interatrial EMDs (OR:1.398, 95% CI: 1.177–1.661, p<0.001) were found to be independently associated with the presence of stroke/TIA.Conclusion:Prolonged inter- and intra-left atrial EMDs in patients with PAF is associated with stroke/TIA. Evaluating this parameter in addition to the CHA2DS2-VASc score in patients with PAF may be helpful in identifying patients who are at a high risk of stroke/TIA. (Anatol J Cardiol 2016; 16: 572-8)

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“…In 108 PAF patients and 52 healthy controls, Hoshi et al found that prolonged AEMD (81%) was frequently associated with PAF, the percentage of which was greater than LA volume index (53%) and lateral A' (52%) [8]. Results of ours were consistent with, and supportive of, those in these previous studies [7,8]. Among patients with prior ischemic stroke, the clinical background similar to our MRFs patients, AEMD was shown to be prolonged (not as much prolonged as in AF patients) compared with normal controls [13] Potential mechanisms of prolonged AEMD in AF Longer AEMD implies more heterogeneous propagation impulse within the atria compromised by fatty replacement [17].…”

Section: Previous Studies On Aemd and Afmentioning

confidence: 99%

“…An increased left atrial (LA) volume index is also known as a strong predictor of AF [3][4][5]. It has been reported that the intra-and interatrial conduction time, that is, the atrial electromechanical delay (AEMD), is an index of reflecting pathological changes of the atria [6][7][8][9][10][11][12][13]. AEMD can be measured not only by invasive electrophysiologic study but also by echocardiographic tissue Doppler imaging (TDI) [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Tissue Doppler-derived Atrial Electromechanical Delay for Identifying Patients with Paroxysmal Atrial Fibrillation

Akamatsu

Ito

Miyamura

et al. 2020

Preprint

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Background: Tissue Doppler imaging (TDI)-derived atrial electromechanical delay (AEMD), has been reported to be useful for predicting development of atrial fibrillation (AF). However, its usefulness remains unknown when analyzed along with patients seemingly at high-risk for AF as controls. From this standpoint, we investigated whether AEMD would be of use for identifying patients with paroxysmal AF (PAF).Methods: We analyzed TDI recordings to obtain AEMD in 73 PAF patients. Thirty-nine patients with multiple cardiovascular risk factors (MRFs) but without history of AF and 61 healthy individuals served as disease and healthy controls, respectively. AEMD was defined as the time-interval between the electrocardiogram P-wave and the beginning of the spectral TDI-derived A' for the septal (septal EMD) and lateral (lateral EMD) sides of the mitral annulus.Results: There was no significant difference in the left atrial volume index between PAF patients and disease controls (28 ± 5 mL/m2 vs. 27 ± 5 mL/m2). PAF patients had longer AEMD, particularly for the lateral EMD (78 ± 26 ms), compared with disease (62 ± 21 ms, P = 0.003) and healthy (53 ± 24 ms, P <0.001) controls. Multivariate logistic regression analysis revealed that the lateral EMD (OR 1.42, 95%CI 1.16 -1.75, P <0.001), along with the left atrial volume index (OR 2.86, 95%CI 1.70 -4.80, P <0.001), was one of the significant independent associates of identifying PAF patients.Conclusions: According to our data, analyzed along with MRFs patients, AEMD seems to be a useful index of identifying patients at risk for AF.

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Atrial Electromechanical Interval May Predict Cardioembolic Stroke in Apparently Low Risk Elderly Patients with Paroxysmal Atrial Fibrillation

Abstract: As compared with echocardiographic parameters of LA size and LA function, AEMI appears to be more useful for identifying PAF patients. AEMI may enable to detect high risk PAF patients, especially those categorized into low risk by CHADS2 score.

Cited by 14 publications

References 33 publications

The Relationships between Atrial Electromechanical Delay and CHA2DS2‐VASc Score in Patients Diagnosed with Paroxysmal AF

The Relationships between Atrial Electromechanical Delay and CHA2DS2‐VASc Score in Patients Diagnosed with Paroxysmal AF

Evaluation of the association between stroke/transient ischemic attack and atrial electromechanical delay in patients with paroxysmal atrial fibrillation

Usefulness of Tissue Doppler-derived Atrial Electromechanical Delay for Identifying Patients with Paroxysmal Atrial Fibrillation

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