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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left ventricular hypertrophy determines the severity of diastolic dysfunction in patients with nonvalvular atrial

Jeonggeun Moon1, Se-Joong Rim, In Jeong Cho

  • 1Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|November 25, 2010
PubMed

Insights

Regression of left ventricular hypertrophy (LVH) in hypertensive patients with nonvalvular atrial fibrillation (NV-AF) is linked to improved outcomes. This study found LVH is independently associated with left atrial enlargement, suggesting LVH regression may improve diastolic function and reduce stroke risk.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Atrial Fibrillation Studies

Background:

  • Regression of left ventricular hypertrophy (LVH) is associated with reduced stroke incidence in hypertensive patients with nonvalvular atrial fibrillation (NV-AF).
  • The precise mechanisms linking LVH regression to improved outcomes in NV-AF remain incompletely understood.
  • Recent findings suggest diastolic dysfunction (DD) correlates with ischemic stroke risk in NV-AF patients.

Purpose of the Study:

  • To investigate the hypothesis that hypertension (HTN) and resultant LVH are associated with the severity of diastolic dysfunction (DD) in NV-AF.
  • To explore the relationship between left ventricular mass index (LVMI) and left atrial (LA) volume in NV-AF patients.

Main Methods:

  • A cohort of 294 patients with NV-AF and preserved LV systolic function were analyzed.
  • Clinical and echocardiographic data were compared between patients with enlarged LA volume and those with normal LA.
  • Multivariate analysis was employed to identify independent predictors of increased LA volume.

Main Results:

  • Patients with enlarged LA volume were older, had a higher prevalence of males, longer NV-AF duration, and elevated brain natriuretic peptide levels.
  • Significant differences were observed in right ventricular systolic pressure, mitral inflow velocity (E), LV mass index (LVMI), and E/E' ratio between groups.
  • Multivariate analysis revealed LVMI was independently correlated with increased LA volume (OR: 1.037 [95% CI: 1.011-1.063], P < 0.05), while HTN was not.

Conclusions:

  • Left atrial enlargement, reflecting DD severity and chronicity, is independently associated with LVH in NV-AF patients.
  • LVMI is a significant independent predictor of LA enlargement in this population.
  • Regression of LVH through antihypertensive treatment may improve diastolic function and lead to favorable clinical outcomes in hypertensive NV-AF patients.

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