Enhanced Left Atrial Reservoir, Increased Conduit, and Weakened Booster Pump Function in Hypertensive Patients with Paroxysmal Atrial Fibrillation

Cui, Qiqiong; Wang, Hu; Zhang, Wei; Wang, Hao; Sun, Xing‐Guo; Zhang, Yun; Yang, Huanyi

doi:10.1291/hypres.31.395

Cited by 25 publications

(23 citation statements)

References 23 publications

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“…However, a few studies have reported impaired reservoir or conduit function in PAF by measuring changes in LA volume. 18,19) Other studies have investigated LA mechanical performance in patients with AF using 2D strain or strain rate. 10,11,20) Murata, et al found that patients who underwent a successful catheter ablation compared to those with recurrent AF revealed a reduced LA volume and improved LA reservoir and booster pump function, assessed by an LA volume change by 3D-STI.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Speckle Tracking Imaging for Assessing Left Atrial Function in Hypertensive Patients With Paroxysmal Atrial Fibrillation

et al. 2016

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SummaryHypertension (HT) is known to be the most prevalent risk factor for paroxysmal atrial fibrillation (PAF), however, its mechanisms have not been fully clarified. Our aim was to investigate the differences in left atrial (LA) function between healthy subjects, and hypertensive patients without PAF (HT-PAF(-)) and with PAF (HT-PAF(+)) using 3-dimensional (3D) speckle tracking imaging (STI). A total of 144 subjects were enrolled: 44 HT-PAF(+) (27 males; mean age 69 ± 10 years), 50 HT-PAF(-) (31 males; mean age 63 ± 11 years), and 50 controls (31 males; mean age 51 ± 14 years). All subjects were in sinus rhythm during the examination. LA volume, LA emptying fraction (LAEF), and LA wall strain were analyzed by 3D area tracking imaging. The maximal value of the global strain curve was defined as the peak global strain. The standard deviation of the time from the R-wave on the electrocardiogram to peak positive values of the segmental strain curves corrected by the R-R' interval in 6 mid LA segments (TP-SD) was calculated to assess LA dyssynchrony. LAEF and peak global strain were lower in HT-PAF(+) than in HT-PAF(-) (P < 0.01) and in the control (P < 0.01). Moreover, TP-SD was higher in HT-PAF(+) than in HT-PAF(-) (P < 0.05) and in the control (P < 0.01). Multivariate analysis revealed LA volume index, peak global strain, and TP-SD were independent determinants of HT-PAF(+). The presence of PAF is associated with diminished LA compliance and advanced mechanical dyssynchrony, as well as LA geometric deformation. (Int Heart J 2016; 57: 705-711) Key words: Three-dimensional echocardiography, Strain, Hypertension, Left atrium A trial fibrillation (AF) is the most common arrhythmia, and its frequency is increasing with the aging of populations. 1,2) Alterations in left atrial (LA) geometry and function, known as LA remodeling, often develop in AF. It is widely known that hypertension (HT) is a risk factor for developing AF and is often synergistically associated with it. Some large animal model studies have provided insights into atrial histological remodeling in HT.3,4) An enlargement of LA is a common finding in patients with HT, indicating hypertensive heart disease. 5,6) Furthermore, many studies have reported that LA enlargement is strongly associated with the incidence of cardiovascular outcomes including the incidence of AF, heart failure, or stroke. 7-9) A better understanding of atrial structure and function in patients with HT is crucial for predicting risk factors for and incidence of AF, as well as complications accompanying the disease.Speckle tracking imaging (STI) is a non-Doppler-based method for the objective quantification of regional myocardial function, independent of ultrasound beam direction. The feasibility of two-dimensional (2D-) STI for measuring LA deformation in patients with paroxysmal or persistent AF has been documented. [10][11][12] Three-dimensional (3D-) STI is thought to be preferable to 2D-STI because the ability of 3D-STI to track echo patterns in 3D-space would eliminate the prob...

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Speckle Tracking Imaging for Assessing Left Atrial Function in Hypertensive Patients With Paroxysmal Atrial Fibrillation

et al. 2016

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“…Consequently, the LA systole, and, implicitly, the LA active emptying volume, will have a smaller contribution to LV filling Moreover, we managed to prove that the LA volume index has a greater prognostic value for diastolic dysfunction development by comparison with the LA area index or the LA diameter index. This is not a surprising result, since diameter measurements have already been dismissed as insufficient by several authors (7,8). In addition to that, we calculated the LA volume index using volume measurements based on the Simpson's single plane modified rule, which seems to be preferred by most, as it considerably reduces errors derived from geometrical assumptions (10).…”

Section: Résultats:-mentioning

confidence: 87%

Left Atrium Function Assessment in Hypertensive Patients.

Ztati¹,

Bendriss²,

Elkhatouri³

2017

IJAR

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“…Therefore, an echocardiographic method is needed as a reference method to relate the left atrial contraction with the AWA-slope. Echocardiographic methods are derived from either atrial volumes (10,23) or mitral flow Doppler data (15,19,24). As the AWA-slope is obtained from a mitral late diastolic flow Doppler tracing, it can naturally be expected that the AWA-slope is associated with mitral flowbased methods.…”

Section: Discussionmentioning

confidence: 99%

“…The left atrial volumes measured included the largest LAV at the end of ventricular systole (LAV max ), the smallest LAV after atrial emptying at the end of ventricular diastole (LAV min ) and the LAV at the onset of atrial emptying coincided with pre-p wave on the electrocardiography (LAV pre-pw ) (23,27). The left atrial active emptying volume (LAV AE ) and the LA-EF were calculated according to the following formulas (23,27,28):…”

Section: Echocardiographic Studymentioning

confidence: 99%

“…While the invasive methods are based on a pressurevolume relationship that is taken simultaneously (16,17), noninvasive methods are generated from either the left atrial volumes (LAVs) (10,23) or mitral flow Doppler data (15,19,24). The left atrial dP/dt, one of the invasive methods, was obtained from the left atrial pressure trace by copying that of the left ventricle (18,19).…”

Section: Introductionmentioning

confidence: 99%

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The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over time

Eren¹,

Öz²

2010

Anadolu Kardiyol Derg

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The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over timeAkut atriyal fibrilasyonda sinüs ritmi elde edildikten sonra mitral geç diyastolik akım akselerasyon eğimi: Atriyal fonksiyonla ilişkisi ve zamanla değişimi Original Investigation Özgün Araşt›rma 488 ABSTRACTObjective: This study was prospectively designed to evaluate the relationship between the mitral A wave acceleration slope (AWA-slope) and the left atrial ejection fraction (LA-EF) after the restoration of sinus rhythm in patients with atrial fibrillation (AF), and also to evaluate the change in the AWA-slope between the sequent second day and first month. Methods: Twenty-nine patients (16 female, mean age 56±13 years) with unknown cause of AF (except for age) converted to sinus rhythm within the first 48 hours were included into the study. A transthoracic echocardiography was performed in all patients on the second day and the first month after restoration of the sinus rhythm. The paired Student's t test was used in comparisons of the continuous variables. The simple and multiple correlations of the LA-EF were evaluated by the simple and multiple linear regression analyses, respectively. Results: Left atrial ejection fraction (42±17 vs 51±19%, p=0.03) and AWA-slope (950±337 vs 1087±351 cm/sec 2 , p=0.021) obtained after the first month were greater than on the second day. A significant correlation between LA-EF and AWA-slope was observed both on the second day (r=0.76, p<0.001) and at the end of the first month (r=0.71, p<0.001). In addition, there were the correlations between LA-EF and mitral A wave peak velocity (r=0.42, p=0.025) or mitral E/A ratio (r=-0.39, p=0.040) at the end of the first month. On multiple linear regression analysis, only AWA-slope was found to be related to LA-EF (y=9.35+0.04 (AWA-slope), the overall R 2 =0.51, beta =0.71; 95% CI 0.02-0.05; p<0.001). Conclusion: Mitral A wave acceleration slope is a simple, reliable and non-invasive method that can be used to evaluate left atrial contractile function. It can also be used in monitoring of atrial stunning period in patients with sinus rhythm converted from AF.(Anadolu Kardiyol Derg 2010 December 1; 10(6): 488-94)

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Enhanced Left Atrial Reservoir, Increased Conduit, and Weakened Booster Pump Function in Hypertensive Patients with Paroxysmal Atrial Fibrillation

Cited by 25 publications

References 23 publications

Three-Dimensional Speckle Tracking Imaging for Assessing Left Atrial Function in Hypertensive Patients With Paroxysmal Atrial Fibrillation

Three-Dimensional Speckle Tracking Imaging for Assessing Left Atrial Function in Hypertensive Patients With Paroxysmal Atrial Fibrillation

Left Atrium Function Assessment in Hypertensive Patients.

The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over time

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