Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling
Objectives This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling. Background Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppre...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2018-09, Vol.35 (9), p.1310-1317 |
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| container_title | Echocardiography (Mount Kisco, N.Y.) |
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| creator | John, Anub G. Hirsch, Glenn A. Stoddard, Marcus F. |
| description | Objectives
This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling.
Background
Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppressive therapy may be beneficial.
Methods
Inclusion criteria were age ≥18 years and sinus rhythm. Exclusion criteria were atrial fibrillation or any etiology for LA enlargement. Hundred and thirty‐two patients with frequent PACs (≥100/24 hours) by Holter were matched to controls. Speckle tracking strain of the left atrium was performed from the 4‐chamber view. Strain measurements were LA peak contractile, reservoir and conduit strain and strain rates.
Results
In the frequent PAC vs control group, PACs were more frequent (1959 ± 3796 vs 28 ± 25/24 hours, P |
| doi_str_mv | 10.1111/echo.14026 |
| format | Article |
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This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling.
Background
Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppressive therapy may be beneficial.
Methods
Inclusion criteria were age ≥18 years and sinus rhythm. Exclusion criteria were atrial fibrillation or any etiology for LA enlargement. Hundred and thirty‐two patients with frequent PACs (≥100/24 hours) by Holter were matched to controls. Speckle tracking strain of the left atrium was performed from the 4‐chamber view. Strain measurements were LA peak contractile, reservoir and conduit strain and strain rates.
Results
In the frequent PAC vs control group, PACs were more frequent (1959 ± 3796 vs 28 ± 25/24 hours, P < .0001). LA peak contractile strain was reduced in the group with frequent PACs vs controls (−7.85 ± 4.12% vs −9.33 ± 4.45%, P = .006). LA peak late negative contractile strain rate was less negative in the frequent PAC vs control group (−0.63 ± 0.27 s−1 vs −0.69 ± 0.32 s−1, P = .051). LA reservoir and conduit strain and strain rates did not differ. LA volume index (LAVI) was larger in the frequent PAC vs control group (26.6 ± 7.8 vs 24.6 ± 8.8 mL/m2, P < .05). Frequent PACs were an independent predictor of reduced LA peak contractile strain and reduced LA peak late negative contractile strain rate.
Conclusions
Patients with frequent PACs have reduced LA peak contractile strain and strain rates and larger LAVI compared to controls. Frequent PACs are an independent predictor of reduced LA peak contractile strain and strain rate. These findings support the hypothesis that frequent PACs impair LA contractile function and promote adverse LA remodeling.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.14026</identifier><identifier>PMID: 29886569</identifier><language>eng</language><publisher>United States</publisher><subject>Atrial Function, Left - physiology ; Atrial Premature Complexes - diagnostic imaging ; Atrial Remodeling - physiology ; Electrocardiography, Ambulatory - methods ; Female ; Heart Atria - diagnostic imaging ; Humans ; left atrial dysfunction ; left atrial strain imaging ; Male ; Middle Aged ; premature atrial complex ; speckle tracking echocardiography</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2018-09, Vol.35 (9), p.1310-1317</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3956-6f14009e94f8b26a88bbe40fef9386ba57370d964c74f9a5ad074055c13337a63</citedby><cites>FETCH-LOGICAL-c3956-6f14009e94f8b26a88bbe40fef9386ba57370d964c74f9a5ad074055c13337a63</cites><orcidid>0000-0003-4852-8704</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.14026$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.14026$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27933,27934,45583,45584</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29886569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>John, Anub G.</creatorcontrib><creatorcontrib>Hirsch, Glenn A.</creatorcontrib><creatorcontrib>Stoddard, Marcus F.</creatorcontrib><title>Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Objectives
This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling.
Background
Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppressive therapy may be beneficial.
Methods
Inclusion criteria were age ≥18 years and sinus rhythm. Exclusion criteria were atrial fibrillation or any etiology for LA enlargement. Hundred and thirty‐two patients with frequent PACs (≥100/24 hours) by Holter were matched to controls. Speckle tracking strain of the left atrium was performed from the 4‐chamber view. Strain measurements were LA peak contractile, reservoir and conduit strain and strain rates.
Results
In the frequent PAC vs control group, PACs were more frequent (1959 ± 3796 vs 28 ± 25/24 hours, P < .0001). LA peak contractile strain was reduced in the group with frequent PACs vs controls (−7.85 ± 4.12% vs −9.33 ± 4.45%, P = .006). LA peak late negative contractile strain rate was less negative in the frequent PAC vs control group (−0.63 ± 0.27 s−1 vs −0.69 ± 0.32 s−1, P = .051). LA reservoir and conduit strain and strain rates did not differ. LA volume index (LAVI) was larger in the frequent PAC vs control group (26.6 ± 7.8 vs 24.6 ± 8.8 mL/m2, P < .05). Frequent PACs were an independent predictor of reduced LA peak contractile strain and reduced LA peak late negative contractile strain rate.
Conclusions
Patients with frequent PACs have reduced LA peak contractile strain and strain rates and larger LAVI compared to controls. Frequent PACs are an independent predictor of reduced LA peak contractile strain and strain rate. These findings support the hypothesis that frequent PACs impair LA contractile function and promote adverse LA remodeling.</description><subject>Atrial Function, Left - physiology</subject><subject>Atrial Premature Complexes - diagnostic imaging</subject><subject>Atrial Remodeling - physiology</subject><subject>Electrocardiography, Ambulatory - methods</subject><subject>Female</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Humans</subject><subject>left atrial dysfunction</subject><subject>left atrial strain imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>premature atrial complex</subject><subject>speckle tracking echocardiography</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kF1LwzAUhoMobk5v_AHSSxE6kzSflzI2Jwi70euStidaaZuZtMr-vdmHggjm5lzkyXPyvghdEjwl8dxC-eqmhGEqjtCYcIZTRSQ_RmMsGU2ponSEzkJ4wxhLQtgpGlGtlOBCj9Fm4eF9gK5P1h5a0w8eEtP72jRJ6brem7KvXReSul2b2icN2P7PfQOJHbodmJiuiibXuj56qg_wAX49iktcBU3dvZyjE2uaABeHOUHPi_nTbJk-ru4fZnePaZlpLlJhYzKsQTOrCiqMUkUBDFuwOlOiMFxmEldasFIyqw03VUyNOS9JlmXSiGyCrvfe-K2YNPR5W4cSmsZ04IaQU8wzKokWOKI3e7T0LgQPNl_7ujV-kxOcb6vOt1Xnu6ojfHXwDkUL1Q_63W0EyB74jA1t_lHl89lytZd-AcTzi4A</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>John, Anub G.</creator><creator>Hirsch, Glenn A.</creator><creator>Stoddard, Marcus F.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4852-8704</orcidid></search><sort><creationdate>201809</creationdate><title>Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling</title><author>John, Anub G. ; Hirsch, Glenn A. ; Stoddard, Marcus F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3956-6f14009e94f8b26a88bbe40fef9386ba57370d964c74f9a5ad074055c13337a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Atrial Function, Left - physiology</topic><topic>Atrial Premature Complexes - diagnostic imaging</topic><topic>Atrial Remodeling - physiology</topic><topic>Electrocardiography, Ambulatory - methods</topic><topic>Female</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Humans</topic><topic>left atrial dysfunction</topic><topic>left atrial strain imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>premature atrial complex</topic><topic>speckle tracking echocardiography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>John, Anub G.</creatorcontrib><creatorcontrib>Hirsch, Glenn A.</creatorcontrib><creatorcontrib>Stoddard, Marcus F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>John, Anub G.</au><au>Hirsch, Glenn A.</au><au>Stoddard, Marcus F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2018-09</date><risdate>2018</risdate><volume>35</volume><issue>9</issue><spage>1310</spage><epage>1317</epage><pages>1310-1317</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Objectives
This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling.
Background
Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppressive therapy may be beneficial.
Methods
Inclusion criteria were age ≥18 years and sinus rhythm. Exclusion criteria were atrial fibrillation or any etiology for LA enlargement. Hundred and thirty‐two patients with frequent PACs (≥100/24 hours) by Holter were matched to controls. Speckle tracking strain of the left atrium was performed from the 4‐chamber view. Strain measurements were LA peak contractile, reservoir and conduit strain and strain rates.
Results
In the frequent PAC vs control group, PACs were more frequent (1959 ± 3796 vs 28 ± 25/24 hours, P < .0001). LA peak contractile strain was reduced in the group with frequent PACs vs controls (−7.85 ± 4.12% vs −9.33 ± 4.45%, P = .006). LA peak late negative contractile strain rate was less negative in the frequent PAC vs control group (−0.63 ± 0.27 s−1 vs −0.69 ± 0.32 s−1, P = .051). LA reservoir and conduit strain and strain rates did not differ. LA volume index (LAVI) was larger in the frequent PAC vs control group (26.6 ± 7.8 vs 24.6 ± 8.8 mL/m2, P < .05). Frequent PACs were an independent predictor of reduced LA peak contractile strain and reduced LA peak late negative contractile strain rate.
Conclusions
Patients with frequent PACs have reduced LA peak contractile strain and strain rates and larger LAVI compared to controls. Frequent PACs are an independent predictor of reduced LA peak contractile strain and strain rate. These findings support the hypothesis that frequent PACs impair LA contractile function and promote adverse LA remodeling.</abstract><cop>United States</cop><pmid>29886569</pmid><doi>10.1111/echo.14026</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4852-8704</orcidid></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Atrial Function, Left - physiology Atrial Premature Complexes - diagnostic imaging Atrial Remodeling - physiology Electrocardiography, Ambulatory - methods Female Heart Atria - diagnostic imaging Humans left atrial dysfunction left atrial strain imaging Male Middle Aged premature atrial complex speckle tracking echocardiography |
| title | Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling |
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