Cardiac Remodeling and Diastolic Dysfunction in Paroxysmal Atrial Fibrillation

Background: Atrial fibrillation (AF) leads to the development of cardiac remodeling/diastolic dysfunction and vice versa. We intended to determine whether cardiac remodeling/diastolic dysfunction is present at early stages of AF. Methods: We studied 175 patients with paroxysmal AF, compared with 175 matched control subjects, who had available echocardiography data to investigate the association between echocardiographic variables and AF from the STANISLAS cohort. Results: In this study (mean age 55 years; 70.3% male), patients with paroxysmal AF had greater left ventricular mass compared to matched controls (p < 0.05). Patients with paroxysmal AF were also likely to have larger left atrial volume and a higher peak tricuspid regurgitation velocity, leading to higher prevalence (though <10% in the AF group) of diastolic dysfunction (all-p < 0.05). Multivariable conditional logistic regression models showed that paroxysmal AF was significantly associated with increased left ventricular mass and left atrial enlargement (all-p < 0.001), but not with e’ and deceleration time of E wave (all-p > 0.1). Conclusions: Left ventricular mass and left atrial enlargement rather than diastolic dysfunction (as evaluated by echocardiography) were associated with paroxysmal AF irrespective of body mass index, blood pressure and renal function. These findings suggest that cardiac remodeling may occur very early in the natural history of AF.

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Left Atrial Size and Left Ventricular Mass Index in Hypertensive Patients

Annals of Clinical Chemistry and Laboratory Medicine ◽

10.3126/acclm.v2i2.15035 ◽

2017 ◽

Vol 2 (2) ◽

pp. 21-25

Author(s):

Kartikesh Kumar Thakur ◽

Ratna Mani Gajurel ◽

Sheelendra Shakya ◽

Aseem Bhattarai ◽

Mithileshwor Raut ◽

...

Keyword(s):

Left Ventricular Mass ◽

Left Atrial ◽

Left Ventricular Mass Index ◽

Left Ventricular ◽

Left Atrial Size ◽

Ventricular Mass Index ◽

Left Atrial Enlargement ◽

Ventricular Mass ◽

Atrial Size ◽

Atrial Enlargement

Background: This study was conducted with the objective of evaluation of the occurrence of left atrial enlargement (LAE) in hypertensive patients and its relationship with left ventricular mass index (LVMI).Methods: This single centre study was carried out at the Manmohan Cardiothoracic Vascular and Transplant Center, where total of 99 patients with hypertension who had left ventricular hypertrophy on echocardiography defined by left ventricular septal wall thickness > 9mm for female and >10 mm for male, were selected from May 2015 to August 2015.Results: In the study, the left atrium was enlarged in 31% of the selected patients. A total of 44% of patients having left atrial enlargement had increased left ventricular mass index as well, while a positive correlation (r = 0.3) was observed between the left atrial size and the left ventricular mass index (p= 0.001). The mean Left Ventricular Mass Index was 98 ± 32.7 g/m2 as compared to 115.34 ± 40.2 in patients with left atrial enlargement. The mean systolic blood pressure with left atrial enlargement was 146.70 ± 21.64 g/m2. Out of 99 patients, 80% of patients with left atrial enlargement had elevated body mass indexes, 48% had a history of smoking, 32% had diabetes mellitus, 22% had other complications of hypertension, and 12% had dyslipidemia.Conclusions: We concluded that the Left Atrial Size correlates significantly with the Left Ventricular Mass Index. In addition, the presence of left atrial enlargement should raise the suspicion of other metabolic derangements in hypertensive patients.Ann. Clin. Chem. Lab. Med. 2016:2(2);21-25

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