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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 Diastolic Indices and Their Impact on Outcomes in Patients with Recently Diagnosed Atrial

Nobuhiro Ikemura1,2, Koki Nakanishi3, John A Spertus2

  • 1Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan.

Journal of Clinical Medicine
|October 14, 2022
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) indices can identify atrial fibrillation (AF) patients at higher risk for heart failure (HF) and adverse outcomes. Early detection of LVDD in AF patients is crucial for risk stratification and improved patient management.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Early identification of atrial fibrillation (AF) patients at risk for heart failure (HF) is critical.
  • Left ventricular diastolic dysfunction (LVDD) may serve as an early indicator in AF patients without a history of HF.

Purpose of the Study:

  • To investigate if LVDD indices can stratify risk in AF patients without clinical HF history.
  • To assess the association between LVDD and clinical outcomes and quality of life in AF patients.

Main Methods:

  • Analysis of 1775 recently diagnosed AF patients with preserved ejection fraction (≥50%).
  • Categorization of LVDD severity (grade 0-3) using mitral deceleration time and E/e’.
  • Two-year follow-up for composite outcomes (death, stroke, HF hospitalization) and Atrial Fibrillation Effects on QualiTy-of-Life (AFEQT) scores.

Main Results:

  • Nearly half (48.3%) of patients exhibited mild or higher LVDD.
  • Primary outcome incidence significantly increased with LVDD grade (p < 0.001).
  • Grade 3 LVDD independently predicted adverse outcomes (aHR 2.28) and was linked to lower AFEQT scores.

Conclusions:

  • LVDD indices are associated with adverse clinical outcomes in AF patients without HF.
  • Diastolic dysfunction assessment aids in risk stratification for AF patients.
  • LVDD impacts both clinical prognosis and patient-reported quality of life.

Keywords:
atrial fibrillationdiastolic dysfunctionheart failurequality of life

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