scholarly journals Differing mechanisms of atrial fibrillation in athletes and non-athletes: alterations in atrial structure and function

2020 ◽  
Vol 21 (12) ◽  
pp. 1374-1383 ◽  
Author(s):  
Siddharth J Trivedi ◽  
Guido Claessen ◽  
Luke Stefani ◽  
M Darragh Flannery ◽  
Paula Brown ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Structure And Function ◽  
Endurance Athletes ◽  
Lv Volume ◽  
Exercise Induced ◽  
Atrial Strain ◽  
And Function ◽  
Minimum Volumes

Abstract Aims Atrial fibrillation (AF) is more common in athletes and may be associated with adverse left atrial (LA) remodelling. We compared LA structure and function in athletes and non-athletes with and without AF. Methods and results Individuals (144) were recruited from four groups (each n = 36): (i) endurance athletes with paroxysmal AF, (ii) endurance athletes without AF, (iii) non-athletes with paroxysmal AF, and (iv) non-athletic healthy controls. Detailed echocardiograms were performed. Athletes had 35% larger LA volumes and 51% larger left ventricular (LV) volumes vs. non-athletes. Non-athletes with AF had increased LA size compared with controls. LA/LV volume ratios were similar in both athlete groups and non-athlete controls, but LA volumes were differentially increased in non-athletes with AF. Diastolic function was impaired in non-athletes with AF vs. non-athletes without, while athletes with and without AF had normal diastolic function. Compared with non-AF athletes, athletes with AF had increased LA minimum volumes (22.6 ± 5.6 vs. 19.2 ± 6.7 mL/m2, P = 0.033), with reduced LA emptying fraction (0.49 ± 0.06 vs. 0.55 ± 0.12, P = 0.02), and LA expansion index (1.0 ± 0.3 vs. 1.2 ± 0.5, P = 0.03). LA reservoir and contractile strain were decreased in athletes and similar to non-athletes with AF. Conclusion Functional associations differed between athletes and non-athletes with AF, suggesting different pathophysiological mechanisms. Diastolic dysfunction and reduced strain defined non-athletes with AF. Athletes had low atrial strain and those with AF had enlarged LA volumes and reduced atrial emptying, but preserved LV diastolic parameters. Thus, AF in athletes may be triggered by an atrial myopathy from exercise-induced haemodynamic stretch consequent to increased cardiac output.

Left Ventricular Structure and Function in Exercise-Induced Eccentric Hypertrophy

1988 ◽  
Vol 2 (1-2) ◽  
pp. 92-97
Author(s):  
Luigi Cassisa ◽  
Gianni DiGirolamo ◽  
Stefano Masia ◽  
Marco Foddanu ◽  
Lorenzo Ibba ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Structure And Function ◽  
Left Ventricular Structure ◽  
Ventricular Structure ◽  
Eccentric Hypertrophy ◽  
Exercise Induced ◽  
And Function

LEFT VENTRICULAR STRUCTURE AND FUNCTION IN ULTRA-ENDURANCE ATHLETES

1985 ◽  
Vol 17 (2) ◽  
pp. 203
Author(s):  
Pamela S. Douglas ◽  
Douglas W. B. Hiller ◽  
Mary L. OʼToole ◽  
Nathaniel Reichek
Keyword(s):  
Left Ventricular ◽  
Structure And Function ◽  
Endurance Athletes ◽  
Left Ventricular Structure ◽  
Ventricular Structure ◽  
And Function ◽  
Ultra Endurance

Effect of 24-Week Treatment with Telmisartan on Myocardial Structure and Function: Relationship to Insertion/Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene

2005 ◽  
Vol 33 (1_suppl) ◽  
pp. 30A-38A ◽  
Author(s):  
AO Conrady ◽  
IO Kiselev ◽  
NI Usachev ◽  
AN Krutikov ◽  
OI Yakovleva ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Diastolic Function ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Structure And Function ◽  
Converting Enzyme ◽  
Ace Gene ◽  
Myocardial Structure ◽  
And Function

The aim of the present study was to assess the effect of treatment with the angiotensin II receptor blocker telmisartan for 24 weeks on myocardial structure and function in patients with essential hypertension, and the relationship between this effect and the structural polymorphism of the angiotensin-converting enzyme (ACE) gene. Thirty-five patients with essential hypertension and left ventricular hypertrophy (LVH) without other associated morbidity were included in an open-label, non-comparative study. The patients were treated with telmisartan 40-80 mg once daily. In the final analysis, there were 29 patients who received the full course of treatment and were evaluated echocardiographically before and after treatment by the same blinded investigator, and myocardial structure and function were analysed. The myocardial mass of the left ventricle was determined in M-mode. Assessment of diastolic function of transmitral blood flow was performed using pulsed Doppler echocardiography. All patients were genotyped for insertion/deletion (I/D) polymorphism of the ACE gene. Telmisartan produced a significant reduction in left ventricular mass index from 140.4 ± 48.6 to 128.7 ± 40.6 g/m2 that was accompanied by an improvement in characteristics of diastolic function. The decrease in LVH was more significant in the ID genotype group than in the II and DD groups. Thus, prolonged treatment with telmisartan is accompanied by an improvement in myocardial structure, expressed as a reduction in left ventricular mass and function that is more marked in patients with ID genotype of the ACE gene.

scholarly journals Change in left atrial function predicts incident atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis

2019 ◽  
Vol 20 (9) ◽  
pp. 979-987 ◽  
Author(s):  
Daniel J Lim ◽  
Bharath Ambale-Ventakesh ◽  
Mohammad R Ostovaneh ◽  
Tarek Zghaib ◽  
Hiroshi Ashikaga ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Left Atrial ◽  
Left Ventricular ◽  
Structure And Function ◽  
Model Discrimination ◽  
Ethnic Study ◽  
Improved Model ◽  
And Function ◽  
Cmr Imaging

Abstract Aims Longitudinal change in left atrial (LA) structure and function could be helpful in predicting risk for incident atrial fibrillation (AF). We used cardiac magnetic resonance (CMR) imaging to explore the relationship between change in LA structure and function and incident AF in a multi-ethnic population free of clinical cardiovascular disease at baseline. Methods and results In the Multi-Ethnic Study of Atherosclerosis (MESA), 2338 participants, free at baseline of clinically recognized AF and cardiovascular disease, had LA volume and function assessed with CMR imaging, at baseline (2000–02), and at Exam 4 (2005–07) or 5 (2010–12). Free of AF, 124 participants developed AF over 3.8 ± 0.9 years (2015) following the second imaging. In adjusted Cox regression models, an average annualized change in all LA parameters were significantly associated with an increased risk of AF. An annual decrease of 1-SD unit in total LA emptying fractions (LAEF) was most strongly associated with risk of AF after adjusting for clinical risk factors for AF, baseline LA parameters, and left ventricular mass-to-volume ratio (hazard ratio per SD = 1.91, 95% confidence interval = 1.53–2.38, P < 0.001). The addition of change in total LAEF to an AF risk score improved model discrimination and reclassification (net reclassification improvement = 0.107, P = 0.017; integrative discrimination index = 0.049, P < 0.001). Conclusion In this multi-ethnic study population free of clinical cardiovascular disease at baseline, a greater increase in LA volumes and decrease in LA function were associated with incident AF. The addition of change in total LAEF to risk prediction models for AF improved model discrimination and reclassification of AF risk.

scholarly journals Left atrial structure and function among different subtypes of atrial fibrillation: an echocardiographic substudy of the AMIO-CAT trial

2020 ◽  
Vol 21 (12) ◽  
pp. 1386-1394
Author(s):  
Flemming Javier Olsen ◽  
Stine Darkner ◽  
Xu Chen ◽  
Steen Pehrson ◽  
Arne Johannessen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Systolic Function ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cross Sectional ◽  
Cardiac Structure And Function ◽  
And Function ◽  
Study Inclusion

Abstract Aims  Little is known about cardiac structure and function among atrial fibrillation (AF) subtypes; paroxysmal AF vs. persistent AF (PxAF), and across AF burden. We sought to assess differences in left atrial (LA) measures by AF subtype and burden. Methods and results  This was a cross-sectional echocardiographic substudy of a randomized trial of AF patients scheduled for catheter ablation. Patients had an echocardiogram performed 0–90 days prior to study inclusion. We performed conventional echocardiographic measures, left ventricular (LV) and LA speckle tracking. Measures were compared between AF subtype and burden (0%, 0–99%, and 99–100%) determined by 72-h Holter monitoring. Of 212 patients, 107 had paroxysmal AF and 105 had PxAF. Those with PxAF had significantly reduced systolic function (LV ejection fraction: 48% vs. 53%; P &lt; 0.001), larger end-systolic and end-diastolic LA volumes (LAVi and LAEDVi), reduced LA emptying fraction (LAEF: 29% vs. 36%, P &lt; 0.001), and reduced LA strain (LAs) (LAs: 20% vs. 26%, P &lt; 0.001). LA measures remained significantly lower in PxAF after multivariable adjustments. All LA measures and measures of systolic function were significantly impaired in patients with 99–100% AF burden, whereas all measures were similar between the other groups (LAVi: 40mL/m2 vs. 33mL/m2 vs. 34mL/m2; LAEDVi: 31mL/m2 vs. 21mL/m2 vs. 22mL/m2, LA emptying fraction: 23% vs. 35% vs. 36%, LAs: 16% vs. 25% vs. 25%, for 99–100%, 0–99%, and 0% AF, respectively, P &lt; 0.001 for all). These differences were consistent after multivariable adjustments. Conclusion  LA mechanics differ between AF subtype and burden and these characteristics influence the clinical interpretation of these measures.

Central Blood Pressure Parameters Correlate with Cardiac Structure and Function in Healthy Chinese Individuals without Cardiovascular Disease

Cardiology ◽  
2018 ◽  
Vol 140 (1) ◽  
pp. 1-7
Author(s):  
Kai Yu ◽  
Xiao-Juan Bai ◽  
Bo Jin ◽  
Xin Zhao ◽  
Lu-Lu Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Diastolic Function ◽  
Density Lipoprotein ◽  
Left Ventricular ◽  
Structure And Function ◽  
Central Blood Pressure ◽  
Cardiac Structure ◽  
Cardiac Structure And Function ◽  
And Function

Purpose: To explore the relationship between central blood pressure (BP) parameters and cardiac structure and function parameters in healthy individuals. Methods: Four hundred Chinese participants with no overt cardiovascular disease participated in this study. One hundred and seventy-one participants (42.8%) were male and the mean age was 60 years. Central BP was measured with the SphygmoCor system. Cardiac structure and function were assessed by echocardiography. Results: We showed a significant association of left atrial volume and left ventricular mass index (LVMI) with brachial and central systolic BP (SBP) and pulse pressure (PP; r = 0.189–0.0.39, p < 0.001). Left ventricular diastolic function and the E/A ratio were significantly associated with brachial and central BP (r = 0.228–0.469, p < 0.001). Multivariate regression analysis revealed that central SBP and PP were independently correlated with LVMI after normalization for age and other confounding variables (sex, body mass index, smoking, and alcohol intake, and the levels of triglycerides, high-density lipoprotein, low-density lipoprotein, creatinine, uric acid, fasting blood glucose, log C-reactive protein, and fibrinogen. However, only central SBP was found to be independently correlated with the E/A ratio. Conclusions: Cardiac structure and diastolic function were associated with brachial and central BP. However, after normalization, cardiac structure parameters were independently correlated with central SBP and PP. Diastolic function was the only cardiac function parameter that correlated with central SBP.

Abstract P044: Intensity Of Hypertensive Exposure In Young Adulthood And Myocardial Structure And Function In Middle Age

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Zhenyu Xiong ◽  
Jiaying Li ◽  
Xiaodong Zhuang ◽  
Xinxue Liao
Keyword(s):  
Diastolic Function ◽  
Young Adulthood ◽  
Longitudinal Strain ◽  
Middle Age ◽  
Early Adulthood ◽  
Left Ventricular ◽  
Structure And Function ◽  
Lv Mass ◽  
Myocardial Structure ◽  
And Function

Background and aims: To measure the association between intensity of hypertensive exposure and myocardial structure and function during a 25-year period in young adulthood. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) Study enrolled 5,115 healthy black and white American aged 18-30 years at baseline (March 1985 to May 2011). Intensity of hypertensive exposure was estimated based on their durations of hypertension over 25 years. Myocardial structure and function was identified by echocardiogram at year 25. Results: Of 2027 participants, 1315 were women (64.9%) and 906 were black (44.7%); mean (SD) age was 24.9 (3.6) at baseline. Duration of stage 1 hypertension was associated with higher left ventricular (LV) structure: LV mass (β [SE], 3.69 [1.80], P < 0.001), relative wall thickness (β [SE], 0.009 [0.003], P = 0.001), worse longitudinal strain (β [SE], 0.27 [0.008], P < 0.001), worse diastolic function: e’ (β [SE], -0.25 [0.07], P < 0.001), E/e’ (β [SE], 0.23 [0.007], P < 0.001). Duration of stage 2 hypertension was associated with higher left ventricular (LV) structure: LV mass (β [SE], 7.30 [2.23], P = 0.001), worse longitudinal strain (β [SE], 0.44 [0.13], P = 0.001), worse diastolic function: e’ (β [SE], -0.77 [0.12], P < 0.001), E/e’ (β [SE], 0.48 [0.13], P < 0.001). Conclusions: In early adulthood, more severe intensity of hypertensive exposure is associated with myocardial structure and diastolic dysfunction in middle age. Key Words: cardiac structure, cardiac dysfunction, hypertension, young adult

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