Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure
Background Left atrial (LA) reservoir strain provides prognostic information in patients with and without heart failure (HF), but might be altered by atrial fibrillation (AF). The aim of the current study was to investigate changes of LA deformation in patients undergoing cardioversion (CV) for firs...
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| Veröffentlicht in: | Clinical research in cardiology 2022-09, Vol.111 (9), p.1028-1039 |
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| creator | von Roeder, Maximilian Blazek, Stephan Rommel, Karl-Philipp Kresoja, Karl-Patrik Gioia, Guglielmo Mentzel, Luise Lurz, Julia Anna Besler, Christian Fengler, Karl Hindricks, Gerhard Desch, Steffen Thiele, Holger Lurz, Philipp |
| description | Background
Left atrial (LA) reservoir strain provides prognostic information in patients with and without heart failure (HF), but might be altered by atrial fibrillation (AF). The aim of the current study was to investigate changes of LA deformation in patients undergoing cardioversion (CV) for first-time diagnosis of AF.
Methods and results
We performed 3D-echocardiography and strain analysis before CV (Baseline), after 25 ± 10 days (FU-1) and after 190 ± 20 days (FU-2). LA volumes, reservoir, conduit and active function were measured. In total, 51 patients were included of whom 35 were in SR at FU-1 (12 HF and preserved ejection fraction (HFpEF)), while 16 had ongoing recurrence of AF (9 HFpEF). LA maximum volume was unaffected by cardioversion (Baseline vs. FU-2: 41 ± 11 vs 40 ± 10 ml/m
2
;
p
= 0.85). Restored SR led to a significant increase in LA reservoir strain (Baseline vs FU-1: 12.9 ± 6.8 vs 24.6 ± 9.4,
p
|
| doi_str_mv | 10.1007/s00392-021-01982-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9424148</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2707720944</sourcerecordid><originalsourceid>FETCH-LOGICAL-c540t-db3e2a42b093e8362d29a67f0f749ad66ce88e081be6a76e663075e742dadf6e3</originalsourceid><addsrcrecordid>eNp9kc9u1DAQxiMEoqXwAhxQJC5cAuM_azsckNCqBaRKXOBsTZLxrqusvdjJSn0JnhmnWxbKgZPHnm9-409fVb1k8JYB6HcZQLS8Ac4aYK0p1aPqnBlVrqrlj0-1kWfVs5xvAFYMhHxanQnZCs40O69-rrcYNpRrH-qR3FTjlDyOtZtDP_kYlvc9Tp7ClOs5DJQ20YdN3WMafDxQyovIxXQa9F3y44jL8Ps60UgHDD3V0T3g5ymhv6NvCdNUO_TjnOh59cThmOnF_XlRfb-6_Lb-3Fx__fRl_fG66VcSpmboBHGUvINWkBGKD7xFpR04LVsclOrJGALDOlKoFSklQK9ISz7g4BSJi-rDkbufux0NfbGXcLT75HeYbm1Ebx92gt_aTTzYVnLJpCmAN_eAFH_MlCe787mnYjxQnLPlinGhjTRQpK__kd7EOYViz3INWnNopSwqflT1KeacyJ0-w8Aucdtj3LbEbe_itgv61d82TiO_8y0CcRTk0io5pz-7_4P9BVSGuVU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2707720944</pqid></control><display><type>article</type><title>Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure</title><source>Springer Nature - Complete Springer Journals</source><creator>von Roeder, Maximilian ; Blazek, Stephan ; Rommel, Karl-Philipp ; Kresoja, Karl-Patrik ; Gioia, Guglielmo ; Mentzel, Luise ; Lurz, Julia Anna ; Besler, Christian ; Fengler, Karl ; Hindricks, Gerhard ; Desch, Steffen ; Thiele, Holger ; Lurz, Philipp</creator><creatorcontrib>von Roeder, Maximilian ; Blazek, Stephan ; Rommel, Karl-Philipp ; Kresoja, Karl-Patrik ; Gioia, Guglielmo ; Mentzel, Luise ; Lurz, Julia Anna ; Besler, Christian ; Fengler, Karl ; Hindricks, Gerhard ; Desch, Steffen ; Thiele, Holger ; Lurz, Philipp</creatorcontrib><description>Background
Left atrial (LA) reservoir strain provides prognostic information in patients with and without heart failure (HF), but might be altered by atrial fibrillation (AF). The aim of the current study was to investigate changes of LA deformation in patients undergoing cardioversion (CV) for first-time diagnosis of AF.
Methods and results
We performed 3D-echocardiography and strain analysis before CV (Baseline), after 25 ± 10 days (FU-1) and after 190 ± 20 days (FU-2). LA volumes, reservoir, conduit and active function were measured. In total, 51 patients were included of whom 35 were in SR at FU-1 (12 HF and preserved ejection fraction (HFpEF)), while 16 had ongoing recurrence of AF (9 HFpEF). LA maximum volume was unaffected by cardioversion (Baseline vs. FU-2: 41 ± 11 vs 40 ± 10 ml/m
2
;
p
= 0.85). Restored SR led to a significant increase in LA reservoir strain (Baseline vs FU-1: 12.9 ± 6.8 vs 24.6 ± 9.4,
p
< 0.0001), mediated by restored LA active strain (SR group Baseline vs. FU-1: 0 ± 0 vs. 12.3 ± 5.3%,
p
< 0.0001), while LA conduit strain remained unchanged (Baseline vs. FU-1: 12.9 ± 6.8 vs 13.1 ± 6.2,
p
= 0.78). Age-controlled LA active strain remained the only significant predictor of LA reservoir strain on multivariable analysis (
β
1.2, CI 1.04–1.4,
p
< 0.0001). HFpEF patients exhibited a significant increase in LA active (8.2 ± 4.3 vs 12.2 ± 6.6%,
p
= 0.004) and reservoir strain (18.3 ± 5.7 vs. 22.8 ± 8.8,
p
= 0.04) between FU-1 and FU-2, associated with improved LV filling (
r
= 0.77,
p
= 0.005).
Conclusion
Reestablished SR improves LA reservoir strain by restoring LA active strain. Despite prolonged atrial stunning following CV, preserved SR might be of hemodynamic and prognostic benefit in HFpEF.
Graphical abstract</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-021-01982-0</identifier><identifier>PMID: 34932171</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Active control ; Cardiac arrhythmia ; Cardiology ; Cardioversion ; Congestive heart failure ; Echocardiography ; Fibrillation ; Heart failure ; Hemodynamics ; Medicine ; Medicine & Public Health ; Original Paper ; Strain analysis</subject><ispartof>Clinical research in cardiology, 2022-09, Vol.111 (9), p.1028-1039</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-db3e2a42b093e8362d29a67f0f749ad66ce88e081be6a76e663075e742dadf6e3</citedby><cites>FETCH-LOGICAL-c540t-db3e2a42b093e8362d29a67f0f749ad66ce88e081be6a76e663075e742dadf6e3</cites><orcidid>0000-0003-3939-2139</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/s00392-021-01982-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-021-01982-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34932171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>von Roeder, Maximilian</creatorcontrib><creatorcontrib>Blazek, Stephan</creatorcontrib><creatorcontrib>Rommel, Karl-Philipp</creatorcontrib><creatorcontrib>Kresoja, Karl-Patrik</creatorcontrib><creatorcontrib>Gioia, Guglielmo</creatorcontrib><creatorcontrib>Mentzel, Luise</creatorcontrib><creatorcontrib>Lurz, Julia Anna</creatorcontrib><creatorcontrib>Besler, Christian</creatorcontrib><creatorcontrib>Fengler, Karl</creatorcontrib><creatorcontrib>Hindricks, Gerhard</creatorcontrib><creatorcontrib>Desch, Steffen</creatorcontrib><creatorcontrib>Thiele, Holger</creatorcontrib><creatorcontrib>Lurz, Philipp</creatorcontrib><title>Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Background
Left atrial (LA) reservoir strain provides prognostic information in patients with and without heart failure (HF), but might be altered by atrial fibrillation (AF). The aim of the current study was to investigate changes of LA deformation in patients undergoing cardioversion (CV) for first-time diagnosis of AF.
Methods and results
We performed 3D-echocardiography and strain analysis before CV (Baseline), after 25 ± 10 days (FU-1) and after 190 ± 20 days (FU-2). LA volumes, reservoir, conduit and active function were measured. In total, 51 patients were included of whom 35 were in SR at FU-1 (12 HF and preserved ejection fraction (HFpEF)), while 16 had ongoing recurrence of AF (9 HFpEF). LA maximum volume was unaffected by cardioversion (Baseline vs. FU-2: 41 ± 11 vs 40 ± 10 ml/m
2
;
p
= 0.85). Restored SR led to a significant increase in LA reservoir strain (Baseline vs FU-1: 12.9 ± 6.8 vs 24.6 ± 9.4,
p
< 0.0001), mediated by restored LA active strain (SR group Baseline vs. FU-1: 0 ± 0 vs. 12.3 ± 5.3%,
p
< 0.0001), while LA conduit strain remained unchanged (Baseline vs. FU-1: 12.9 ± 6.8 vs 13.1 ± 6.2,
p
= 0.78). Age-controlled LA active strain remained the only significant predictor of LA reservoir strain on multivariable analysis (
β
1.2, CI 1.04–1.4,
p
< 0.0001). HFpEF patients exhibited a significant increase in LA active (8.2 ± 4.3 vs 12.2 ± 6.6%,
p
= 0.004) and reservoir strain (18.3 ± 5.7 vs. 22.8 ± 8.8,
p
= 0.04) between FU-1 and FU-2, associated with improved LV filling (
r
= 0.77,
p
= 0.005).
Conclusion
Reestablished SR improves LA reservoir strain by restoring LA active strain. Despite prolonged atrial stunning following CV, preserved SR might be of hemodynamic and prognostic benefit in HFpEF.
Graphical abstract</description><subject>Active control</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardioversion</subject><subject>Congestive heart failure</subject><subject>Echocardiography</subject><subject>Fibrillation</subject><subject>Heart failure</subject><subject>Hemodynamics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Strain analysis</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc9u1DAQxiMEoqXwAhxQJC5cAuM_azsckNCqBaRKXOBsTZLxrqusvdjJSn0JnhmnWxbKgZPHnm9-409fVb1k8JYB6HcZQLS8Ac4aYK0p1aPqnBlVrqrlj0-1kWfVs5xvAFYMhHxanQnZCs40O69-rrcYNpRrH-qR3FTjlDyOtZtDP_kYlvc9Tp7ClOs5DJQ20YdN3WMafDxQyovIxXQa9F3y44jL8Ps60UgHDD3V0T3g5ymhv6NvCdNUO_TjnOh59cThmOnF_XlRfb-6_Lb-3Fx__fRl_fG66VcSpmboBHGUvINWkBGKD7xFpR04LVsclOrJGALDOlKoFSklQK9ISz7g4BSJi-rDkbufux0NfbGXcLT75HeYbm1Ebx92gt_aTTzYVnLJpCmAN_eAFH_MlCe787mnYjxQnLPlinGhjTRQpK__kd7EOYViz3INWnNopSwqflT1KeacyJ0-w8Aucdtj3LbEbe_itgv61d82TiO_8y0CcRTk0io5pz-7_4P9BVSGuVU</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>von Roeder, Maximilian</creator><creator>Blazek, Stephan</creator><creator>Rommel, Karl-Philipp</creator><creator>Kresoja, Karl-Patrik</creator><creator>Gioia, Guglielmo</creator><creator>Mentzel, Luise</creator><creator>Lurz, Julia Anna</creator><creator>Besler, Christian</creator><creator>Fengler, Karl</creator><creator>Hindricks, Gerhard</creator><creator>Desch, Steffen</creator><creator>Thiele, Holger</creator><creator>Lurz, Philipp</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</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>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3939-2139</orcidid></search><sort><creationdate>20220901</creationdate><title>Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure</title><author>von Roeder, Maximilian ; Blazek, Stephan ; Rommel, Karl-Philipp ; Kresoja, Karl-Patrik ; Gioia, Guglielmo ; Mentzel, Luise ; Lurz, Julia Anna ; Besler, Christian ; Fengler, Karl ; Hindricks, Gerhard ; Desch, Steffen ; Thiele, Holger ; Lurz, Philipp</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-db3e2a42b093e8362d29a67f0f749ad66ce88e081be6a76e663075e742dadf6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Active control</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardioversion</topic><topic>Congestive heart failure</topic><topic>Echocardiography</topic><topic>Fibrillation</topic><topic>Heart failure</topic><topic>Hemodynamics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Strain analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>von Roeder, Maximilian</creatorcontrib><creatorcontrib>Blazek, Stephan</creatorcontrib><creatorcontrib>Rommel, Karl-Philipp</creatorcontrib><creatorcontrib>Kresoja, Karl-Patrik</creatorcontrib><creatorcontrib>Gioia, Guglielmo</creatorcontrib><creatorcontrib>Mentzel, Luise</creatorcontrib><creatorcontrib>Lurz, Julia Anna</creatorcontrib><creatorcontrib>Besler, Christian</creatorcontrib><creatorcontrib>Fengler, Karl</creatorcontrib><creatorcontrib>Hindricks, Gerhard</creatorcontrib><creatorcontrib>Desch, Steffen</creatorcontrib><creatorcontrib>Thiele, Holger</creatorcontrib><creatorcontrib>Lurz, Philipp</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</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>Biochemistry Abstracts 1</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>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>von Roeder, Maximilian</au><au>Blazek, Stephan</au><au>Rommel, Karl-Philipp</au><au>Kresoja, Karl-Patrik</au><au>Gioia, Guglielmo</au><au>Mentzel, Luise</au><au>Lurz, Julia Anna</au><au>Besler, Christian</au><au>Fengler, Karl</au><au>Hindricks, Gerhard</au><au>Desch, Steffen</au><au>Thiele, Holger</au><au>Lurz, Philipp</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>111</volume><issue>9</issue><spage>1028</spage><epage>1039</epage><pages>1028-1039</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Background
Left atrial (LA) reservoir strain provides prognostic information in patients with and without heart failure (HF), but might be altered by atrial fibrillation (AF). The aim of the current study was to investigate changes of LA deformation in patients undergoing cardioversion (CV) for first-time diagnosis of AF.
Methods and results
We performed 3D-echocardiography and strain analysis before CV (Baseline), after 25 ± 10 days (FU-1) and after 190 ± 20 days (FU-2). LA volumes, reservoir, conduit and active function were measured. In total, 51 patients were included of whom 35 were in SR at FU-1 (12 HF and preserved ejection fraction (HFpEF)), while 16 had ongoing recurrence of AF (9 HFpEF). LA maximum volume was unaffected by cardioversion (Baseline vs. FU-2: 41 ± 11 vs 40 ± 10 ml/m
2
;
p
= 0.85). Restored SR led to a significant increase in LA reservoir strain (Baseline vs FU-1: 12.9 ± 6.8 vs 24.6 ± 9.4,
p
< 0.0001), mediated by restored LA active strain (SR group Baseline vs. FU-1: 0 ± 0 vs. 12.3 ± 5.3%,
p
< 0.0001), while LA conduit strain remained unchanged (Baseline vs. FU-1: 12.9 ± 6.8 vs 13.1 ± 6.2,
p
= 0.78). Age-controlled LA active strain remained the only significant predictor of LA reservoir strain on multivariable analysis (
β
1.2, CI 1.04–1.4,
p
< 0.0001). HFpEF patients exhibited a significant increase in LA active (8.2 ± 4.3 vs 12.2 ± 6.6%,
p
= 0.004) and reservoir strain (18.3 ± 5.7 vs. 22.8 ± 8.8,
p
= 0.04) between FU-1 and FU-2, associated with improved LV filling (
r
= 0.77,
p
= 0.005).
Conclusion
Reestablished SR improves LA reservoir strain by restoring LA active strain. Despite prolonged atrial stunning following CV, preserved SR might be of hemodynamic and prognostic benefit in HFpEF.
Graphical abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34932171</pmid><doi>10.1007/s00392-021-01982-0</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-3939-2139</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2022-09, Vol.111 (9), p.1028-1039 |
| issn | 1861-0684 1861-0692 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9424148 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Active control Cardiac arrhythmia Cardiology Cardioversion Congestive heart failure Echocardiography Fibrillation Heart failure Hemodynamics Medicine Medicine & Public Health Original Paper Strain analysis |
| title | Changes in left atrial function in patients undergoing cardioversion for atrial fibrillation: relevance of left atrial strain in heart failure |
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