Related Experiment Video

Updated: Aug 24, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

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Assessment of the Left Ventricular Diastolic Function and Its Association with the Left Atrial Pressure in Patients

Mi-Na Kim1, Seong-Mi Park1, Hee-Dong Kim1

  • 1Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.

International Journal of Heart Failure
|October 20, 2022
PubMed

Insights

The current guidelines for diagnosing left ventricular diastolic dysfunction in atrial fibrillation patients may not accurately reflect elevated left atrial pressure. Diastolic parameters show limited value in paroxysmal AF.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Electrophysiology

Background:

  • Assessing left ventricular (LV) diastolic function in atrial fibrillation (AF) presents challenges.
  • Current diagnostic algorithms for LV diastolic dysfunction (LVDD) may not fully capture elevated left atrial pressure (LAP) in AF patients.

Purpose of the Study:

  • To evaluate the diagnostic algorithm for LVDD in current guidelines.
  • To assess the association between elevated LAP and LV diastolic parameters in AF patients.

Main Methods:

  • 124 patients with non-valvular AF and preserved LV ejection fraction were analyzed.
  • LV diastolic function was categorized using current guidelines.
  • Elevated LAP was defined as mean LAP (mLAP) ≥15 mmHg, measured during catheter ablation.

Main Results:

  • mLAP did not differ across LVDD severity groups, but increased LAP prevalence was higher in the LVDD group.
  • Medial E/e' was the only LV diastolic parameter independently associated with mLAP overall.
  • In persistent AF, E/e' and e' correlated with mLAP; in paroxysmal AF, mLAP associated with left atrial conduit function, not diastolic parameters.

Conclusions:

  • The current LVDD diagnostic algorithm inadequately reflects elevated LAP in AF patients.
  • LV diastolic parameters may help estimate elevated LAP in persistent AF but have limited utility in paroxysmal AF.
Abstract

Keywords:
Atrial fibrillationAtrial pressureDiastoleEchocardiography

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