Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation
Purpose To identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium. Methods Wall thickness was measured by computed tomography and LVA (% area with bipolar volta...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2020-09, Vol.58 (3), p.315-321 |
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| creator | Nakatani, Yosuke Sakamoto, Tamotsu Yamaguchi, Yoshiaki Tsujino, Yasushi Kataoka, Naoya Kinugawa, Koichiro |
| description | Purpose
To identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium.
Methods
Wall thickness was measured by computed tomography and LVA (% area with bipolar voltage 10% of segment surface area) was observed in 123 of 215 segments (57%). Segments in the low tertile of wall thickness ( |
| doi_str_mv | 10.1007/s10840-019-00611-1 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2273217531</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2272482719</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-79375ce4ed637a1b912169c02750fff229663271d14b33b16f180618c4f8e8143</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi1ERT_gD3BAlrhwMZ2xk9g5ogoo0kpcisTNcrLj1iUbL7aXpf8eL1lA4tDTWJrHz4zmZewlwlsE0JcZwTQgAHsB0CEKfMLOsNVSmLZvn9a3MkoY3X49Zec53wNAD7J7xk4VNgga1BlLK_KFu5KCm_jeTRMvd2H8NlPOPGTuco5jcIXWfB_KXW0Sn-Je_IhTcbfEXSLHw8y3rgSaS16orUvx50PeVOXR7MOQwjRVKs7P2Yl3U6YXx3rBvnx4f3N1LVafP366ercSo9JtEbqvZaSG1p3SDoceJXb9CFK34L2Xsu86JTWusRmUGrDzaOoVzNh4QwYbdcHeLN5tit93lIvdhDxS3WKmuMtWSq0k6lZhRV__h97HXZrrdgdKNqbO6SslF2pMMedE3m5T2Lj0YBHsIRG7JGJrIvZ3IvagfnVU74YNrf9--RNBBdQC5Nqabyn9m_2I9heLZJYh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2272482719</pqid></control><display><type>article</type><title>Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation</title><source>SpringerLink Journals - AutoHoldings</source><creator>Nakatani, Yosuke ; Sakamoto, Tamotsu ; Yamaguchi, Yoshiaki ; Tsujino, Yasushi ; Kataoka, Naoya ; Kinugawa, Koichiro</creator><creatorcontrib>Nakatani, Yosuke ; Sakamoto, Tamotsu ; Yamaguchi, Yoshiaki ; Tsujino, Yasushi ; Kataoka, Naoya ; Kinugawa, Koichiro</creatorcontrib><description>Purpose
To identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium.
Methods
Wall thickness was measured by computed tomography and LVA (% area with bipolar voltage < 0.5 mV) by voltage mapping in 43 paroxysmal AF patients. The left atrium was divided into five segments: septal wall, anterior wall, roof wall, posterior wall, and bottom wall in regional analysis.
Results
Left atrial wall thickness and LVA were 3.2 ± 0.6 mm and 14% ± 9%, respectively. Multivariate analysis identified left atrial wall thickness and volume as independent determinants of left atrial LVA (thickness, standardized
β
− 0.374, 95%CI − 23.289 to − 4.534,
P
= 0.005; volume, standardized
β
0.452, 95%CI 0.049–0.214,
P
= 0.002). In regional analysis, significant LVA (> 10% of segment surface area) was observed in 123 of 215 segments (57%). Segments in the low tertile of wall thickness (< 1.76 mm) had larger LVAs compared with segments in middle (1.76–2.14 mm) and high tertiles (≥ 2.14 mm) (low tertile, 20.3% ± 14.9%; middle tertile, 12.6% ± 11.2%; high tertile, 12.5% ± 12.1%; low vs. middle tertile,
P
= 0.001; low vs. high tertile,
P
= 0.001). Area under the receiver operating curve of wall thickness was 0.706 for prediction of significant LVA. A thickness cut-off of 1.90 mm yielded 62% sensitivity, 73% specificity, 75% positive predictive value, and 59% negative predictive value for significant LVA.
Conclusion
A thin left atrial wall is an independent predictor of LVA in patients with paroxysmal AF.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-019-00611-1</identifier><identifier>PMID: 31410703</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Atria ; Atrium ; Cardiology ; Computed tomography ; Electric potential ; Fibrillation ; Mapping ; Measurement methods ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Predictions ; Regional analysis ; Regional planning ; Segments ; Thickness measurement ; Voltage ; Wall thickness</subject><ispartof>Journal of interventional cardiac electrophysiology, 2020-09, Vol.58 (3), p.315-321</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-79375ce4ed637a1b912169c02750fff229663271d14b33b16f180618c4f8e8143</citedby><cites>FETCH-LOGICAL-c375t-79375ce4ed637a1b912169c02750fff229663271d14b33b16f180618c4f8e8143</cites><orcidid>0000-0002-5427-5048</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-019-00611-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-019-00611-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31410703$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakatani, Yosuke</creatorcontrib><creatorcontrib>Sakamoto, Tamotsu</creatorcontrib><creatorcontrib>Yamaguchi, Yoshiaki</creatorcontrib><creatorcontrib>Tsujino, Yasushi</creatorcontrib><creatorcontrib>Kataoka, Naoya</creatorcontrib><creatorcontrib>Kinugawa, Koichiro</creatorcontrib><title>Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
To identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium.
Methods
Wall thickness was measured by computed tomography and LVA (% area with bipolar voltage < 0.5 mV) by voltage mapping in 43 paroxysmal AF patients. The left atrium was divided into five segments: septal wall, anterior wall, roof wall, posterior wall, and bottom wall in regional analysis.
Results
Left atrial wall thickness and LVA were 3.2 ± 0.6 mm and 14% ± 9%, respectively. Multivariate analysis identified left atrial wall thickness and volume as independent determinants of left atrial LVA (thickness, standardized
β
− 0.374, 95%CI − 23.289 to − 4.534,
P
= 0.005; volume, standardized
β
0.452, 95%CI 0.049–0.214,
P
= 0.002). In regional analysis, significant LVA (> 10% of segment surface area) was observed in 123 of 215 segments (57%). Segments in the low tertile of wall thickness (< 1.76 mm) had larger LVAs compared with segments in middle (1.76–2.14 mm) and high tertiles (≥ 2.14 mm) (low tertile, 20.3% ± 14.9%; middle tertile, 12.6% ± 11.2%; high tertile, 12.5% ± 12.1%; low vs. middle tertile,
P
= 0.001; low vs. high tertile,
P
= 0.001). Area under the receiver operating curve of wall thickness was 0.706 for prediction of significant LVA. A thickness cut-off of 1.90 mm yielded 62% sensitivity, 73% specificity, 75% positive predictive value, and 59% negative predictive value for significant LVA.
Conclusion
A thin left atrial wall is an independent predictor of LVA in patients with paroxysmal AF.</description><subject>Atria</subject><subject>Atrium</subject><subject>Cardiology</subject><subject>Computed tomography</subject><subject>Electric potential</subject><subject>Fibrillation</subject><subject>Mapping</subject><subject>Measurement methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Predictions</subject><subject>Regional analysis</subject><subject>Regional planning</subject><subject>Segments</subject><subject>Thickness measurement</subject><subject>Voltage</subject><subject>Wall thickness</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1v1DAQhi1ERT_gD3BAlrhwMZ2xk9g5ogoo0kpcisTNcrLj1iUbL7aXpf8eL1lA4tDTWJrHz4zmZewlwlsE0JcZwTQgAHsB0CEKfMLOsNVSmLZvn9a3MkoY3X49Zec53wNAD7J7xk4VNgga1BlLK_KFu5KCm_jeTRMvd2H8NlPOPGTuco5jcIXWfB_KXW0Sn-Je_IhTcbfEXSLHw8y3rgSaS16orUvx50PeVOXR7MOQwjRVKs7P2Yl3U6YXx3rBvnx4f3N1LVafP366ercSo9JtEbqvZaSG1p3SDoceJXb9CFK34L2Xsu86JTWusRmUGrDzaOoVzNh4QwYbdcHeLN5tit93lIvdhDxS3WKmuMtWSq0k6lZhRV__h97HXZrrdgdKNqbO6SslF2pMMedE3m5T2Lj0YBHsIRG7JGJrIvZ3IvagfnVU74YNrf9--RNBBdQC5Nqabyn9m_2I9heLZJYh</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Nakatani, Yosuke</creator><creator>Sakamoto, Tamotsu</creator><creator>Yamaguchi, Yoshiaki</creator><creator>Tsujino, Yasushi</creator><creator>Kataoka, Naoya</creator><creator>Kinugawa, Koichiro</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5427-5048</orcidid></search><sort><creationdate>20200901</creationdate><title>Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation</title><author>Nakatani, Yosuke ; Sakamoto, Tamotsu ; Yamaguchi, Yoshiaki ; Tsujino, Yasushi ; Kataoka, Naoya ; Kinugawa, Koichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-79375ce4ed637a1b912169c02750fff229663271d14b33b16f180618c4f8e8143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Atria</topic><topic>Atrium</topic><topic>Cardiology</topic><topic>Computed tomography</topic><topic>Electric potential</topic><topic>Fibrillation</topic><topic>Mapping</topic><topic>Measurement methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Predictions</topic><topic>Regional analysis</topic><topic>Regional planning</topic><topic>Segments</topic><topic>Thickness measurement</topic><topic>Voltage</topic><topic>Wall thickness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakatani, Yosuke</creatorcontrib><creatorcontrib>Sakamoto, Tamotsu</creatorcontrib><creatorcontrib>Yamaguchi, Yoshiaki</creatorcontrib><creatorcontrib>Tsujino, Yasushi</creatorcontrib><creatorcontrib>Kataoka, Naoya</creatorcontrib><creatorcontrib>Kinugawa, Koichiro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakatani, Yosuke</au><au>Sakamoto, Tamotsu</au><au>Yamaguchi, Yoshiaki</au><au>Tsujino, Yasushi</au><au>Kataoka, Naoya</au><au>Kinugawa, Koichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>58</volume><issue>3</issue><spage>315</spage><epage>321</epage><pages>315-321</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
To identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium.
Methods
Wall thickness was measured by computed tomography and LVA (% area with bipolar voltage < 0.5 mV) by voltage mapping in 43 paroxysmal AF patients. The left atrium was divided into five segments: septal wall, anterior wall, roof wall, posterior wall, and bottom wall in regional analysis.
Results
Left atrial wall thickness and LVA were 3.2 ± 0.6 mm and 14% ± 9%, respectively. Multivariate analysis identified left atrial wall thickness and volume as independent determinants of left atrial LVA (thickness, standardized
β
− 0.374, 95%CI − 23.289 to − 4.534,
P
= 0.005; volume, standardized
β
0.452, 95%CI 0.049–0.214,
P
= 0.002). In regional analysis, significant LVA (> 10% of segment surface area) was observed in 123 of 215 segments (57%). Segments in the low tertile of wall thickness (< 1.76 mm) had larger LVAs compared with segments in middle (1.76–2.14 mm) and high tertiles (≥ 2.14 mm) (low tertile, 20.3% ± 14.9%; middle tertile, 12.6% ± 11.2%; high tertile, 12.5% ± 12.1%; low vs. middle tertile,
P
= 0.001; low vs. high tertile,
P
= 0.001). Area under the receiver operating curve of wall thickness was 0.706 for prediction of significant LVA. A thickness cut-off of 1.90 mm yielded 62% sensitivity, 73% specificity, 75% positive predictive value, and 59% negative predictive value for significant LVA.
Conclusion
A thin left atrial wall is an independent predictor of LVA in patients with paroxysmal AF.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31410703</pmid><doi>10.1007/s10840-019-00611-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5427-5048</orcidid></addata></record> |
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| ispartof | Journal of interventional cardiac electrophysiology, 2020-09, Vol.58 (3), p.315-321 |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Atria Atrium Cardiology Computed tomography Electric potential Fibrillation Mapping Measurement methods Medicine Medicine & Public Health Multivariate analysis Predictions Regional analysis Regional planning Segments Thickness measurement Voltage Wall thickness |
| title | Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation |
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