Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation
Impaired atrial functional reserve during exercise may represent an early stage of atrial cardiomyopathy. To test this hypothesis, the authors evaluated left atrial (LA) and left ventricular (LV) function reserve during exercise in patients with paroxysmal atrial fibrillation (PAF). Sixty-one patien...
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| Veröffentlicht in: | Journal of the American Society of Echocardiography 2023-02, Vol.36 (2), p.180-188 |
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| container_title | Journal of the American Society of Echocardiography |
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| creator | Cho, Dong-Hyuk Kim, Yun Gi Choi, Jimi Kim, Hee-Dong Kim, Mi-Na Shim, Jaemin Choi, Jong-Il Kim, Young-Hoon Shim, Wan-Joo Park, Seong-Mi |
| description | Impaired atrial functional reserve during exercise may represent an early stage of atrial cardiomyopathy. To test this hypothesis, the authors evaluated left atrial (LA) and left ventricular (LV) function reserve during exercise in patients with paroxysmal atrial fibrillation (PAF).
Sixty-one patients with PAF undergoing radiofrequency catheter ablation and 38 healthy control subjects were prospectively enrolled. LV global longitudinal strain and LA reservoir strain (RS) were measured at rest and during supine bicycle exercise. To identify the early stage of atrial cardiomyopathy without LA structural remodeling, patients with PAF were divided into two groups according to LA volume index (LAVI): atrial fibrillation (AF) group 1 (LAVI ≥ 34 mL/m2) and AF group 2 (LAVI < 34 mL/m2).
LV ejection fraction and global longitudinal strain did not differ between patients with AF and control subjects. LAVI and LA RS did not differ between AF group 2 and control subjects. During exercise, LV global longitudinal strain improved in all groups. Increases in LA RS were attenuated in both AF groups, which also exhibited lower LA functional reserve index than the control subjects. Although resting LA RS was similar between AF group 2 and control subjects, LA functional reserve index was significantly lower in AF group 2. LA functional reserve index was associated with risk for AF recurrence (hazard ratio, 0.852; 95% CI, 0.736-0.988).
Atrial cardiomyopathy can be anticipated by impaired LA functional reserve during exercise in patients with AF, even in those with normal-sized left atria. Atrial cardiomyopathy occurs independently of changes in LV function and is associated with the recurrence of AF in patients with PAF after radiofrequency catheter ablation.
[Display omitted]
•LA and LV function was evaluated in patients with AF via exercise echocardiography.•Exercise unmasked the impaired LA functional reserve in the AF group.•LV functional reserve did not differ between patients with AF and control subjects.•Isolated LA functional remodeling may precede structural remodeling. |
| doi_str_mv | 10.1016/j.echo.2022.09.012 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2718636093</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0894731722004771</els_id><sourcerecordid>2718636093</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-b612e34c5a17535109b7545143fca8fd361388a08a922758e1c80be7d3651f083</originalsourceid><addsrcrecordid>eNp9kMFqGzEQhkVJaFy3L9BD2GMuux1J1koLvRgTp4ZATGnPQqudxTLelSvJTv32kbHTY09zmO__mfkI-UqhokDrb9sK7cZXDBiroKmAsg9kQqGRZS0bcUMmoJpZKTmVd-RTjFsAEArgI7njNa2ZlHRC-nkKzuyKhQmd88PJ703anIpXlzbFatgbF7ArlofRJufHzP3EiOGIhRuLtUkOxxQv8NoE__cUh8xcK5euDW63M-fkZ3Lbm13EL9c5Jb-Xj78WP8rnl6fVYv5cWi7qVLY1ZchnVhgqBRf5l1aKmaAz3luj-i7fzZUyoEzDmBQKqVXQoswLQXtQfEoeLr374P8cMCY9uGgxXzGiP0TNJFU1r6HhGWUX1AYfY8Be74MbTDhpCvrsV2_12a8--9XQ6Ow3h-6v_Yd2wO5f5F1oBr5fAMxfHh0GHW22ZLHLJm3SnXf_638D8ZSMOQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2718636093</pqid></control><display><type>article</type><title>Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Cho, Dong-Hyuk ; Kim, Yun Gi ; Choi, Jimi ; Kim, Hee-Dong ; Kim, Mi-Na ; Shim, Jaemin ; Choi, Jong-Il ; Kim, Young-Hoon ; Shim, Wan-Joo ; Park, Seong-Mi</creator><creatorcontrib>Cho, Dong-Hyuk ; Kim, Yun Gi ; Choi, Jimi ; Kim, Hee-Dong ; Kim, Mi-Na ; Shim, Jaemin ; Choi, Jong-Il ; Kim, Young-Hoon ; Shim, Wan-Joo ; Park, Seong-Mi</creatorcontrib><description>Impaired atrial functional reserve during exercise may represent an early stage of atrial cardiomyopathy. To test this hypothesis, the authors evaluated left atrial (LA) and left ventricular (LV) function reserve during exercise in patients with paroxysmal atrial fibrillation (PAF).
Sixty-one patients with PAF undergoing radiofrequency catheter ablation and 38 healthy control subjects were prospectively enrolled. LV global longitudinal strain and LA reservoir strain (RS) were measured at rest and during supine bicycle exercise. To identify the early stage of atrial cardiomyopathy without LA structural remodeling, patients with PAF were divided into two groups according to LA volume index (LAVI): atrial fibrillation (AF) group 1 (LAVI ≥ 34 mL/m2) and AF group 2 (LAVI < 34 mL/m2).
LV ejection fraction and global longitudinal strain did not differ between patients with AF and control subjects. LAVI and LA RS did not differ between AF group 2 and control subjects. During exercise, LV global longitudinal strain improved in all groups. Increases in LA RS were attenuated in both AF groups, which also exhibited lower LA functional reserve index than the control subjects. Although resting LA RS was similar between AF group 2 and control subjects, LA functional reserve index was significantly lower in AF group 2. LA functional reserve index was associated with risk for AF recurrence (hazard ratio, 0.852; 95% CI, 0.736-0.988).
Atrial cardiomyopathy can be anticipated by impaired LA functional reserve during exercise in patients with AF, even in those with normal-sized left atria. Atrial cardiomyopathy occurs independently of changes in LV function and is associated with the recurrence of AF in patients with PAF after radiofrequency catheter ablation.
[Display omitted]
•LA and LV function was evaluated in patients with AF via exercise echocardiography.•Exercise unmasked the impaired LA functional reserve in the AF group.•LV functional reserve did not differ between patients with AF and control subjects.•Isolated LA functional remodeling may precede structural remodeling.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2022.09.012</identifier><identifier>PMID: 36162771</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Arrhythmia ; Atrial Appendage ; Atrial fibrillation ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - surgery ; Atrial Remodeling ; Cardiomyopathies - complications ; Cardiomyopathies - diagnostic imaging ; Cardiomyopathy ; Catheter Ablation ; Heart Atria - diagnostic imaging ; Humans ; Reserve ; Strain ; Ventricular Function, Left</subject><ispartof>Journal of the American Society of Echocardiography, 2023-02, Vol.36 (2), p.180-188</ispartof><rights>2022 American Society of Echocardiography</rights><rights>Copyright © 2022 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-b612e34c5a17535109b7545143fca8fd361388a08a922758e1c80be7d3651f083</citedby><cites>FETCH-LOGICAL-c356t-b612e34c5a17535109b7545143fca8fd361388a08a922758e1c80be7d3651f083</cites><orcidid>0000-0002-6710-685X ; 0000-0001-8480-9082</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.echo.2022.09.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36162771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cho, Dong-Hyuk</creatorcontrib><creatorcontrib>Kim, Yun Gi</creatorcontrib><creatorcontrib>Choi, Jimi</creatorcontrib><creatorcontrib>Kim, Hee-Dong</creatorcontrib><creatorcontrib>Kim, Mi-Na</creatorcontrib><creatorcontrib>Shim, Jaemin</creatorcontrib><creatorcontrib>Choi, Jong-Il</creatorcontrib><creatorcontrib>Kim, Young-Hoon</creatorcontrib><creatorcontrib>Shim, Wan-Joo</creatorcontrib><creatorcontrib>Park, Seong-Mi</creatorcontrib><title>Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Impaired atrial functional reserve during exercise may represent an early stage of atrial cardiomyopathy. To test this hypothesis, the authors evaluated left atrial (LA) and left ventricular (LV) function reserve during exercise in patients with paroxysmal atrial fibrillation (PAF).
Sixty-one patients with PAF undergoing radiofrequency catheter ablation and 38 healthy control subjects were prospectively enrolled. LV global longitudinal strain and LA reservoir strain (RS) were measured at rest and during supine bicycle exercise. To identify the early stage of atrial cardiomyopathy without LA structural remodeling, patients with PAF were divided into two groups according to LA volume index (LAVI): atrial fibrillation (AF) group 1 (LAVI ≥ 34 mL/m2) and AF group 2 (LAVI < 34 mL/m2).
LV ejection fraction and global longitudinal strain did not differ between patients with AF and control subjects. LAVI and LA RS did not differ between AF group 2 and control subjects. During exercise, LV global longitudinal strain improved in all groups. Increases in LA RS were attenuated in both AF groups, which also exhibited lower LA functional reserve index than the control subjects. Although resting LA RS was similar between AF group 2 and control subjects, LA functional reserve index was significantly lower in AF group 2. LA functional reserve index was associated with risk for AF recurrence (hazard ratio, 0.852; 95% CI, 0.736-0.988).
Atrial cardiomyopathy can be anticipated by impaired LA functional reserve during exercise in patients with AF, even in those with normal-sized left atria. Atrial cardiomyopathy occurs independently of changes in LV function and is associated with the recurrence of AF in patients with PAF after radiofrequency catheter ablation.
[Display omitted]
•LA and LV function was evaluated in patients with AF via exercise echocardiography.•Exercise unmasked the impaired LA functional reserve in the AF group.•LV functional reserve did not differ between patients with AF and control subjects.•Isolated LA functional remodeling may precede structural remodeling.</description><subject>Arrhythmia</subject><subject>Atrial Appendage</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - surgery</subject><subject>Atrial Remodeling</subject><subject>Cardiomyopathies - complications</subject><subject>Cardiomyopathies - diagnostic imaging</subject><subject>Cardiomyopathy</subject><subject>Catheter Ablation</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Humans</subject><subject>Reserve</subject><subject>Strain</subject><subject>Ventricular Function, Left</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFqGzEQhkVJaFy3L9BD2GMuux1J1koLvRgTp4ZATGnPQqudxTLelSvJTv32kbHTY09zmO__mfkI-UqhokDrb9sK7cZXDBiroKmAsg9kQqGRZS0bcUMmoJpZKTmVd-RTjFsAEArgI7njNa2ZlHRC-nkKzuyKhQmd88PJ703anIpXlzbFatgbF7ArlofRJufHzP3EiOGIhRuLtUkOxxQv8NoE__cUh8xcK5euDW63M-fkZ3Lbm13EL9c5Jb-Xj78WP8rnl6fVYv5cWi7qVLY1ZchnVhgqBRf5l1aKmaAz3luj-i7fzZUyoEzDmBQKqVXQoswLQXtQfEoeLr374P8cMCY9uGgxXzGiP0TNJFU1r6HhGWUX1AYfY8Be74MbTDhpCvrsV2_12a8--9XQ6Ow3h-6v_Yd2wO5f5F1oBr5fAMxfHh0GHW22ZLHLJm3SnXf_638D8ZSMOQ</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Cho, Dong-Hyuk</creator><creator>Kim, Yun Gi</creator><creator>Choi, Jimi</creator><creator>Kim, Hee-Dong</creator><creator>Kim, Mi-Na</creator><creator>Shim, Jaemin</creator><creator>Choi, Jong-Il</creator><creator>Kim, Young-Hoon</creator><creator>Shim, Wan-Joo</creator><creator>Park, Seong-Mi</creator><general>Elsevier Inc</general><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/0000-0002-6710-685X</orcidid><orcidid>https://orcid.org/0000-0001-8480-9082</orcidid></search><sort><creationdate>202302</creationdate><title>Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation</title><author>Cho, Dong-Hyuk ; Kim, Yun Gi ; Choi, Jimi ; Kim, Hee-Dong ; Kim, Mi-Na ; Shim, Jaemin ; Choi, Jong-Il ; Kim, Young-Hoon ; Shim, Wan-Joo ; Park, Seong-Mi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-b612e34c5a17535109b7545143fca8fd361388a08a922758e1c80be7d3651f083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arrhythmia</topic><topic>Atrial Appendage</topic><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - surgery</topic><topic>Atrial Remodeling</topic><topic>Cardiomyopathies - complications</topic><topic>Cardiomyopathies - diagnostic imaging</topic><topic>Cardiomyopathy</topic><topic>Catheter Ablation</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Humans</topic><topic>Reserve</topic><topic>Strain</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cho, Dong-Hyuk</creatorcontrib><creatorcontrib>Kim, Yun Gi</creatorcontrib><creatorcontrib>Choi, Jimi</creatorcontrib><creatorcontrib>Kim, Hee-Dong</creatorcontrib><creatorcontrib>Kim, Mi-Na</creatorcontrib><creatorcontrib>Shim, Jaemin</creatorcontrib><creatorcontrib>Choi, Jong-Il</creatorcontrib><creatorcontrib>Kim, Young-Hoon</creatorcontrib><creatorcontrib>Shim, Wan-Joo</creatorcontrib><creatorcontrib>Park, Seong-Mi</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>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cho, Dong-Hyuk</au><au>Kim, Yun Gi</au><au>Choi, Jimi</au><au>Kim, Hee-Dong</au><au>Kim, Mi-Na</au><au>Shim, Jaemin</au><au>Choi, Jong-Il</au><au>Kim, Young-Hoon</au><au>Shim, Wan-Joo</au><au>Park, Seong-Mi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2023-02</date><risdate>2023</risdate><volume>36</volume><issue>2</issue><spage>180</spage><epage>188</epage><pages>180-188</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Impaired atrial functional reserve during exercise may represent an early stage of atrial cardiomyopathy. To test this hypothesis, the authors evaluated left atrial (LA) and left ventricular (LV) function reserve during exercise in patients with paroxysmal atrial fibrillation (PAF).
Sixty-one patients with PAF undergoing radiofrequency catheter ablation and 38 healthy control subjects were prospectively enrolled. LV global longitudinal strain and LA reservoir strain (RS) were measured at rest and during supine bicycle exercise. To identify the early stage of atrial cardiomyopathy without LA structural remodeling, patients with PAF were divided into two groups according to LA volume index (LAVI): atrial fibrillation (AF) group 1 (LAVI ≥ 34 mL/m2) and AF group 2 (LAVI < 34 mL/m2).
LV ejection fraction and global longitudinal strain did not differ between patients with AF and control subjects. LAVI and LA RS did not differ between AF group 2 and control subjects. During exercise, LV global longitudinal strain improved in all groups. Increases in LA RS were attenuated in both AF groups, which also exhibited lower LA functional reserve index than the control subjects. Although resting LA RS was similar between AF group 2 and control subjects, LA functional reserve index was significantly lower in AF group 2. LA functional reserve index was associated with risk for AF recurrence (hazard ratio, 0.852; 95% CI, 0.736-0.988).
Atrial cardiomyopathy can be anticipated by impaired LA functional reserve during exercise in patients with AF, even in those with normal-sized left atria. Atrial cardiomyopathy occurs independently of changes in LV function and is associated with the recurrence of AF in patients with PAF after radiofrequency catheter ablation.
[Display omitted]
•LA and LV function was evaluated in patients with AF via exercise echocardiography.•Exercise unmasked the impaired LA functional reserve in the AF group.•LV functional reserve did not differ between patients with AF and control subjects.•Isolated LA functional remodeling may precede structural remodeling.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36162771</pmid><doi>10.1016/j.echo.2022.09.012</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6710-685X</orcidid><orcidid>https://orcid.org/0000-0001-8480-9082</orcidid></addata></record> |
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| identifier | ISSN: 0894-7317 |
| ispartof | Journal of the American Society of Echocardiography, 2023-02, Vol.36 (2), p.180-188 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Arrhythmia Atrial Appendage Atrial fibrillation Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - surgery Atrial Remodeling Cardiomyopathies - complications Cardiomyopathies - diagnostic imaging Cardiomyopathy Catheter Ablation Heart Atria - diagnostic imaging Humans Reserve Strain Ventricular Function, Left |
| title | Atrial Cardiomyopathy with Impaired Functional Reserve in Patients with Paroxysmal Atrial Fibrillation |
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