Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression

Romano, Letizia Rosa; Scalzi, Giuseppe; Malizia, Biagio; Aquila, Iolanda; Polimeni, Alberto; Indolfi, Ciro; Curcio, Antonio

doi:10.3390/jcdd10080320

Cited by 7 publications

(5 citation statements)

References 34 publications

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“…Additionally, for every 1% increase in PALS, the risk of new-onset AF decreased by 3% (HR 0.97, 95% CI: 0.95–0.98, P<0.001). Recently, Romano et al ( 19 ) confirmed the improvement of LA strain and AF burden in patients with severe mitral regurgitation following transcatheter edge-to-edge repair. Furthermore, a good correlation was observed between PAF burden and LA reservoir strain (R_s), with R_s serving as a significant predictor of AF burden.…”

Section: Discussionmentioning

confidence: 92%

Study on the relationship between atrial high-rate episode and left atrial strain in patients with cardiac implantable electronic device

Wang,

Huang,

Fang

et al. 2024

Quant Imaging Med Surg

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Background Although atrial high-rate episode (AHRE) and atrial fibrillation (AF) cannot entirely be identical, recent studies suggest AHRE is linked to AF development and shares some characteristics with AF regarding thromboembolism. At present, there is still lack of predictive indicators for AHRE and diagnostic methods and clinical indicators for AHRE in patients without cardiac implantable electronic device (CIED). The aim of this study was thus to explore the relationship between AHRE and left atrial (LA) strain parameters with the goal of identifying high-risk populations of AHRE by LA strain characteristics. Methods From February 2022 to May 2023, a total of 105 CIED patients were enrolled and divided into two groups based on whether AHRE had occurred: AHRE (−) group (n=65) and AHRE (+) group (n=40). Real-time three-dimensional echocardiography (RT-3DE) technique was used to obtain the LA time-volume curve. The collected dynamic images were analyzed on the Echopac 204 workstation to obtain the parameters of LA. The four-dimensional automatic LA quantitative analysis (4D Auto LAQ) technology was used to analyze the LA strain parameters: LA reservoir longitudinal strain (LASr), LA conduit longitudinal strain (LAScd), LA contraction longitudinal strain (LASct), LA reservoir circumferential strain (LASr-c), LA conduit circumferential strain (LAScd-c), LA contraction circumferential strain (LASct-c). Correlation analysis was carried out using Binary logistic regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic performance of LASct in AHRE. Results Body surface area (BSA) [odds ratio (OR) =8.34, 95% confidence interval (CI): 1.32–72.30, P=0.037], LASct (OR =1.20, 95% CI: 1.05–1.39, P=0.013) and LA end-systolic volume (LAESV) (OR =1.02, 95% CI: 1.00–1.04, P=0.023) were the influencing factors of AHRE. Only LASct (OR =1.18, 95% CI: 1.01–1.38, P=0.041) was found to be an independent influencing factor of AHRE. This result remained significant after adjusting for age, sex, hypertension, diabetes, and stroke history. The ROC curve showed that the cut-off for predicting AHRE was LASct =−4.125% with sensitivity of 37.5% and specificity of 87.7%. Conclusions This cross-sectional study found that decreased LASct (absolute value) is an independent risk factor for the AHRE and has diagnostic efficacy in certain degree for the occurrence of AHRE.

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Section: Discussionmentioning

confidence: 92%

Study on the relationship between atrial high-rate episode and left atrial strain in patients with cardiac implantable electronic device

Wang,

Huang,

Fang

et al. 2024

Quant Imaging Med Surg

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“…Second, the inclusion of redo-ablations may have induced bias due to prior ablations, which could have affected the AF substrate. Third, the lack of data regarding the LA LGE or LA global and regional strain; LA changes measured by 2DSTE, precisely, in the transport function were associated with AF occurrence and could have influenced the AF burden in our cohort of patients [17]. Fourth, the short period of follow-up raises the possibility that recurrent AF episodes might have been missed.…”

Section: Limitationsmentioning

confidence: 91%

Left Atrial Low-Voltage Areas Predict the Risk of Atrial Fibrillation Recurrence after Radiofrequency Ablation

Mitran,

Popa-Fotea,

Iorgulescu

et al. 2023

Biomedicines

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Atrial fibrillation (AF), the most frequently encountered arrhythmia worldwide, is associated with increased cardiovascular morbidity and mortality. Left atrial (LA) and antral region of the pulmonary veins (PVs) remodeling are risk factors for AF perpetuation. Among the methods of LA fibrosis quantification, bipolar voltage mapping during three-dimensional electro-anatomical mapping is less studied. The main aim of this study was to analyze the relationship between the degree of LA fibrosis quantified in low-voltage areas and the efficacy of AF radiofrequency catheter ablation. All consecutive patients with AF ablation were included, and the degree of LA fibrosis was measured based on the low-voltage areas in the LA and the antral region of PVs (<0.5 mV for patients in sinus rhythm and <0.25 mV for patients in AF at the time of the ablation procedure). The efficacy of AF ablation was determined by the rate of recurrence after a blanking period of three months. A total of 106 patients were included; from these, 38 (35.8%) had AF recurrence after RF ablation, while 68 (64.2%) were free of events. The area and percentage of LA fibrosis were significantly higher in the patients with AF recurrence (p = 0.018 and p = 0.019, respectively). However, no significant differences were found between the patients with and without AF recurrence in terms of the area and percentage of PVs fibrosis (p = 0.896 and p = 0.888, respectively). Moreover, LA fibrosis parameters proved to be excellent predictors for AF recurrence (areas under the curve of 0.834 and 0.832, respectively, p < 0.001) even after adjustment for LA indexed volume and CHA2DS2-VASc score. In conclusion, LA fibrosis measured on bipolar voltage maps increases the risk of AF recurrence after the RF catheter ablation procedure.

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“…In addition, moderate drinking in patients with AF is linked to a noteworthy enlargement of the left atrium and a compromised transport function. On the other hand, remodeling of the atrium after transcatheter edge-to-edge repair reduces AF burden over long follow-up in patients with mitral valve disease due to multiple etiologies [97].…”

Section: Ethanol-induced Afmentioning

confidence: 99%

Pathophysiology of Atrial Fibrillation and Approach to Therapy in Subjects Less than 60 Years Old

Curcio,

Scalise,

Indolfi

2024

IJMS

Self Cite

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Atrial fibrillation (AF) is an arrhythmia that affects the left atrium, cardiac function, and the patients’ survival rate. Due to empowered diagnostics, it has become increasingly recognized among young individuals as well, in whom it is influenced by a complex interplay of autoimmune, inflammatory, and electrophysiological mechanisms. Deepening our understanding of these mechanisms could contribute to improving AF management and treatment. Inflammation is a complexly regulated process, with interactions among various immune cell types, signaling molecules, and complement components. Addressing circulating antibodies and designing specific autoantibodies are promising therapeutic options. In cardiomyopathies or channelopathies, the first manifestation could be paroxysmal AF; persistent forms tend not to respond to antiarrhythmic drugs in these conditions. Further research, both in vitro and in vivo, on the use of genomic biotechnology could lead to new therapeutic approaches. Additional triggers that can be encountered in AF patients below 60 years of age are systemic hypertension, overweight, diabetes, and alcohol abuse. The aims of this review are to briefly report evidence from basic science and results of clinical studies that might explain the juvenile burden of the most encountered sustained supraventricular tachyarrhythmias in the general population.

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Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression

Cited by 7 publications

References 34 publications

Study on the relationship between atrial high-rate episode and left atrial strain in patients with cardiac implantable electronic device

Study on the relationship between atrial high-rate episode and left atrial strain in patients with cardiac implantable electronic device

Left Atrial Low-Voltage Areas Predict the Risk of Atrial Fibrillation Recurrence after Radiofrequency Ablation

Pathophysiology of Atrial Fibrillation and Approach to Therapy in Subjects Less than 60 Years Old

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