Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation

Tae Hoon Kim, ChiYoung Shim, Jae Hyung Park, Chung Mo Nam, Jae Sun Uhm, Boyoung Joung, Moon Hyoung Lee, huinam pak

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Abstract

Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increased E/Em is related to an advanced LA remodeling, a high CHA2DS2-VASc score, and the presence of stroke or transient ischemic attack (TIA) in patients with paroxysmal AF. Methods We included 1098 patients with paroxysmal AF (male 74.5%, 57.6 ± 11.3 years old) who underwent AF catheter ablation. We compared E/Em to clinical parameters, echocardiography, and three-dimensional-computed tomography findings. Results The E/Em > 15 group (n = 98) was older (p < 0.001) and had more females (p < 0.001), greater LA volume index (p < 0.001), higher CHA2DS2-VASc score (p < 0.001), and stroke/TIA prevalence (p = 0.001) than groups with an E/Em of 8–15 (n = 676) or <8 (n = 324). An E/Em was independently associated with the presence of stroke/TIA (OR 1.638, 95% CI 1.050–2.554, p = 0.030) after adjusting for age, sex, body surface area, LA volume index, and LA appendage volume index. Conclusions In patients with paroxysmal AF, the elevated LV filling pressure estimated by E/Em is independently associated with the presence of stroke or TIA.

Original languageEnglish
Pages (from-to)104-109
Number of pages6
JournalJournal of Cardiology
Volume68
Issue number2
DOIs
Publication statusPublished - 2016 Aug 1

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Atrial Remodeling
Left Ventricular Dysfunction
Heart Atria
Atrial Fibrillation
Transient Ischemic Attack
Stroke
Ventricular Pressure
Three-Dimensional Echocardiography
Atrial Appendage
Catheter Ablation
Body Surface Area
Left Ventricular Function
Tomography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{840703e61dc743ec9bed31f3e1a28eb7,
title = "Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation",
abstract = "Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increased E/Em is related to an advanced LA remodeling, a high CHA2DS2-VASc score, and the presence of stroke or transient ischemic attack (TIA) in patients with paroxysmal AF. Methods We included 1098 patients with paroxysmal AF (male 74.5{\%}, 57.6 ± 11.3 years old) who underwent AF catheter ablation. We compared E/Em to clinical parameters, echocardiography, and three-dimensional-computed tomography findings. Results The E/Em > 15 group (n = 98) was older (p < 0.001) and had more females (p < 0.001), greater LA volume index (p < 0.001), higher CHA2DS2-VASc score (p < 0.001), and stroke/TIA prevalence (p = 0.001) than groups with an E/Em of 8–15 (n = 676) or <8 (n = 324). An E/Em was independently associated with the presence of stroke/TIA (OR 1.638, 95{\%} CI 1.050–2.554, p = 0.030) after adjusting for age, sex, body surface area, LA volume index, and LA appendage volume index. Conclusions In patients with paroxysmal AF, the elevated LV filling pressure estimated by E/Em is independently associated with the presence of stroke or TIA.",
author = "Kim, {Tae Hoon} and ChiYoung Shim and Park, {Jae Hyung} and Nam, {Chung Mo} and Uhm, {Jae Sun} and Boyoung Joung and Lee, {Moon Hyoung} and huinam pak",
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doi = "10.1016/j.jjcc.2015.10.008",
language = "English",
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Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation. / Kim, Tae Hoon; Shim, ChiYoung; Park, Jae Hyung; Nam, Chung Mo; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung; pak, huinam.

In: Journal of Cardiology, Vol. 68, No. 2, 01.08.2016, p. 104-109.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Left ventricular diastolic dysfunction is associated with atrial remodeling and risk or presence of stroke in patients with paroxysmal atrial fibrillation

AU - Kim, Tae Hoon

AU - Shim, ChiYoung

AU - Park, Jae Hyung

AU - Nam, Chung Mo

AU - Uhm, Jae Sun

AU - Joung, Boyoung

AU - Lee, Moon Hyoung

AU - pak, huinam

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increased E/Em is related to an advanced LA remodeling, a high CHA2DS2-VASc score, and the presence of stroke or transient ischemic attack (TIA) in patients with paroxysmal AF. Methods We included 1098 patients with paroxysmal AF (male 74.5%, 57.6 ± 11.3 years old) who underwent AF catheter ablation. We compared E/Em to clinical parameters, echocardiography, and three-dimensional-computed tomography findings. Results The E/Em > 15 group (n = 98) was older (p < 0.001) and had more females (p < 0.001), greater LA volume index (p < 0.001), higher CHA2DS2-VASc score (p < 0.001), and stroke/TIA prevalence (p = 0.001) than groups with an E/Em of 8–15 (n = 676) or <8 (n = 324). An E/Em was independently associated with the presence of stroke/TIA (OR 1.638, 95% CI 1.050–2.554, p = 0.030) after adjusting for age, sex, body surface area, LA volume index, and LA appendage volume index. Conclusions In patients with paroxysmal AF, the elevated LV filling pressure estimated by E/Em is independently associated with the presence of stroke or TIA.

AB - Background Although the degree of electroanatomical remodeling of the left atrium (LA) is influenced by left ventricular (LV) diastolic function, clinical implications of estimated LV filling pressure (E/Em) are limited in patients with atrial fibrillation (AF). We hypothesized that increased E/Em is related to an advanced LA remodeling, a high CHA2DS2-VASc score, and the presence of stroke or transient ischemic attack (TIA) in patients with paroxysmal AF. Methods We included 1098 patients with paroxysmal AF (male 74.5%, 57.6 ± 11.3 years old) who underwent AF catheter ablation. We compared E/Em to clinical parameters, echocardiography, and three-dimensional-computed tomography findings. Results The E/Em > 15 group (n = 98) was older (p < 0.001) and had more females (p < 0.001), greater LA volume index (p < 0.001), higher CHA2DS2-VASc score (p < 0.001), and stroke/TIA prevalence (p = 0.001) than groups with an E/Em of 8–15 (n = 676) or <8 (n = 324). An E/Em was independently associated with the presence of stroke/TIA (OR 1.638, 95% CI 1.050–2.554, p = 0.030) after adjusting for age, sex, body surface area, LA volume index, and LA appendage volume index. Conclusions In patients with paroxysmal AF, the elevated LV filling pressure estimated by E/Em is independently associated with the presence of stroke or TIA.

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DO - 10.1016/j.jjcc.2015.10.008

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JO - Journal of cardiography. Supplement

JF - Journal of cardiography. Supplement

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