Evaluatıon Of The Effect Of Pulmonary Veın Isolatıon Treatment With Left Atrıal Catheter Ablatıon Method On Atrıal Conductıon Tımes In Patıents With Paroxysmal Atrıal Fıbrıllatıon

Purpose:Atrial fibrillation(AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra- and interatrial conduction time, which is measured by tissue doppler echocardiography, indicates structural and electrical remodeling in the atrium. The aim of this study was to evaluate the effect of pulmonary vein isolation applied with RF ablation therapy on intra- and interatrial conduction time and to investigate the structural and electrically remodeling after treatment. Methods:Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 ± 11.731; mean left atrial diameter: 36.79 ± 4.318) who underwent CARTO® 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra- and the inter-atrial electromechanical delay was measured in all patients by tissue doppler echocardiography before and three months after RF ablation. Results:All intra- and interatrial conduction times were significantly decreased 3 months after RF ablation procedure(PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029). Conclusion:The results of our study suggest that providing stable sinus rhythm by the elimination of the AF triggering mechanisms with RF ablation of pulmonary vein isolation may slow down,stop or even improve structural remodeling at substrate level secondary to AF even in patients who did not yet develop atrial fibrosis and permanent structural changes.

Reference values of left ventricular diastolic function accessed by conventional and Doppler echocardiography in healthy Angolans: effect of age and gender

Introduction: Studies about the reference values of the conventional and tissue Doppler echocardiography in African populations are limited. Objectives: The aim of this study is to evaluate the effect of aging and gender in left ventricular diastolic function assessed by conventional and tissue Doppler echocardiography in healthy Angolans. Methods: Cross-sectional study performed involving healthy participants aged between 18 and 85 years, attending in a diagnostic center in Luanda, Angola. Two-dimensional transthoracic echocardiography and Doppler study were performed according to the Guidelines of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Results: A total of 103 men (47.5%) (mean age: 39,5±10,8) and 114 women (52,5%) (mean age: 43,0±12,5 years) were included. Compared to men, women were older (p=0,025) and showed significantly smaller body surface area (p<0,001). Mitral E velocity, and E/e’ ratio were significantly higher in women compared to men. While, DT of mitral E velocity was longer in men compared to women (p=0,041), E wave velocity and E/A ratio show a negative significant correlation with increasing age (r -0,33; P ≤ 0.001 and r -0,48; P ≤ 0.001, respectively). Conversely, A wave velocity shows a significant positive correlation with age (r 0,47; P < 0.001). Average e′ wave velocity shows a significant negative correlation with aging (r -0,40; P ≤ 0.0001). Conclusions: In healthy Angolan adult population, the parameters of left ventricular diastolic function deteriorated with age reflecting a normal aging process. This must be taken into account when assessing diastolic function at different age’s categories.

Abnormal myocardial performance index in M-mode color tissue Doppler-echocardiography

The myocardial performance index (MPI) is used for global systolic-diastolic left ventricular function and prognosis assessment in patients with heart disease, allowing assessment of the patient‘s current condition and disease development follow-up. The classic method of calculation is pulsed Doppler echocardiography. The aim of the study was to evaluate the correlation of myocardial performance index with established left ventricular systolic and diastolic function indices and to determine cut-off values of the myocardial performance index in M-mode color tissue Doppler echocardiography through the aortic and mitral valves predicting abnormal myocardial performance index by pulsed Doppler echocardiography. One hundred and fi ve subjects were studied, including 30 healthy controls, 45 hypertensive patients, and 30 patients with CHD. MPI was calculated using pulsed Doppler (MPIPW) and M-mode color tissue Doppler echocardiography through the aortic (MPIAO1 and MPIAO2) and mitral (MPIMV) valves. In all patients, the myocardial performance index showed a low to moderatenegative correlation with the left ventricular ejection fraction, and the correlation with the diastolic function indices was moderate to high. In healthy persons, the correlations were not signifi cant in almost all comparisons. The MPIAO1, MPIAO2,and MPIMV values predicting abnormal MPI by pulsed Doppler (MPIPW ≥ 0.50) are MPIAO1 ≥ 0.578, MPIAO2 ≥ 0.446, and MPIMV ≥ 0.552. The cut-off values of MPI by M-mode color tissue Doppler echocardiography through the aortic and mitral valve obtained can be used for global left ventricular function assessment in patients with heart disease. Further studies, on a larger number of patients, are necessary to estimate the predictive value of the parameters established.