Higher Degree of Left Atrial Structural Remodeling in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction.
LV Systolic Dysfunction is Related to LA-SRM in AF Patients Background Catheter ablation significantly improves the left ventricular (LV) function in patients with atrial fibrillation (AF) and LV systolic dysfunction. In this study, we compared the degree of left atrial structural remodeling (LA-SRM...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 24; no. 5; pp. 485 - 492 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104280842&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104280842 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: May2013 vid: 24 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104280842 87339178 10.1111/jce.12090 NLM23373748 104280842 ppf: 485 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Higher Degree of Left Atrial Structural Remodeling in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction. aug: au: Akkaya, Mehmet Higuchi, Koji Koopmann, Matthias Damal, Kavitha Burgon, Nathan S. Kholmovski, Eugene McGANN, Chris Marrouche, Nassir affil: Comprehensive Arrhythmia Research and Management Center (CARMA), University of Utah sug: subj: Atrial Fibrillation Therapy Systolic Pressure Heart Ventricle, Left Pathology Catheter Ablation Human Descriptive Statistics Ventricular Ejection Fraction Retrospective Design Utah Academic Medical Centers Magnetic Resonance Imaging Echocardiography Aged Middle Age Male Female Data Analysis Software T-Tests One-Way Analysis of Variance Post Hoc Analysis Chi Square Test Fisher's Exact Test Fibrosis Diagnosis Aged: 65+ years Middle Aged: 45-64 years Male Female ab: LV Systolic Dysfunction is Related to LA-SRM in AF Patients Background Catheter ablation significantly improves the left ventricular (LV) function in patients with atrial fibrillation (AF) and LV systolic dysfunction. In this study, we compared the degree of left atrial structural remodeling (LA-SRM) in patients with normal versus reduced LV ejection fraction (LVEF). We also studied the impact of LA-SRM on LVEF improvement in patients undergoing ablation of AF. Method and Results We categorized 384 patients into 2 groups based on their cardiac function: reduced LVEF group (LVEF ≤50%; n = 105) and normal LVEF group (LVEF > 50%; n = 279). LVEF was determined prior and mean 8 ± 3 months after catheter ablation for AF. Percentage of LA-SRM was quantified using LGE-MRI and patients were classified into 4 groups based on the amount of structural remodeling in their LA wall: minimal ≤ 5%, mild = 5-20%, moderate = 20-35%, and extensive ≥ 35%. The average preablation LA-SRM (21.5 ± 13.2% vs 15.4 ± 10.0%; P < 0.001) was significantly higher in reduced LVEF group than normal LVEF group. Among the 105 patients with reduced LVEF, while there was a modest 11.7 ± 8.4% average increase in LVEF following ablation, the greatest increase was seen in patients with less extensive LA-SRM (minimal = 19.3 ± 5.1%, n = 3, P = 0.02 and mild = 16.6 ± 9.9%, n = 48, P < 0.001). Patients with moderate and extensive fibrosis had an average EF improvement of 8.7 ± 11.1% and 2.8 ± 6.4%, respectively (n = 39, P < 0.001 and n = 15, P = 0.11, respectively). Conclusion Patients with LV systolic dysfunction displayed a comparatively greater LA-SRM than patients with normal LVEF. Patients with lesser LA-SRM experienced a greater improvement in LVEF after catheter ablation for AF. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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