Left atrial function during exercise stress echocardiography as a sign of paroxysmal/persistent atrial fibrillation.

Autor: Zagatina A; Cardiology Department, Research Cardiocenter 'Medika', St. Petersburg, Russian Federation. zag_angel@yahoo.com., Ciampi Q; Fatebenefratelli Hospital of Benevento, Benevento, Italy., Peteiro JV; CHUAC- Complexo Hospitalario Universitario A Coruna- University of A Coruna, La Coruna, Spain., Kalinina E; Cardiology Department, Research Cardiocenter 'Medika', St. Petersburg, Russian Federation., Begidova I; Cardiology Department, Research Cardiocenter 'Medika', St. Petersburg, Russian Federation., Padang R; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Boshchenko A; Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation., Merli E; Cardiology Unit, Ospedale Per Gli Infermi, Faenza, Italy., Lisi M; Department of Cardiovascular Disease, Division of Cardiology, AUSL Romagna, Ospedale S. Maria Delle Croci, Ravenna, Italy., Rodriguez-Zanella H; Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico., Kobal S; Echocardiography Unit, Soroka University Medical Center, Be'er Sheva, Israel., Agoston G; Institute of Family Medicine, University of Szeged, Szeged, Hungary., Varga A; Institute of Family Medicine, University of Szeged, Szeged, Hungary., Wierzbowska-Drabik K; Department of Internal Disease and Clinical Pharmacology, Medical University, Lodz, Poland., Kasprzak JD; First Department and Chair of Cardiology, Medical University of Lodz, Bieganski Specialty Hospital, Lodz, Poland., Arbucci R; Investigaciones Medicas, Buenos Aires, Argentina., Zhuravleva O; Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation., Čelutkienė J; Centre of Cardiology and Angiology, Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Centre of Innovative Medicine, Vilnius, Lithuania., Lowenstein J; Investigaciones Medicas, Buenos Aires, Argentina., Ratanasit NC; Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand., Colonna P; Department of Cardiology, Policlinico Hospital, Bari, Italy., Carerj S; Divisione Di Cardiologia, Policlinico UniversitarioUniversità Di Messina, Messina, Italy., Pepi M; Centro Cardiologico Monzino, IRCCS, Milan, Italy., Pellikka PA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Picano E; Cardiology Clinic, University Center Serbia, Medical School, University of Belgrade, Belgrade, Serbia.
Jazyk: angličtina
Zdroj: Cardiovascular ultrasound [Cardiovasc Ultrasound] 2024 Nov 04; Vol. 22 (1), pp. 13. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1186/s12947-024-00332-0
Abstrakt: Objective: Atrial cardiomyopathy is closely associated with atrial fibrillation (AF), and some patients exhibit no dysfunction at rest but demonstrate evident changes in left atrial (LA) function and LA volume during exercise. This study aimed to identify distinguishing signs during exercise stress echocardiography (ESE) among patients in sinus rhythm (SR), with and without history of paroxysmal/persistent AF (PAF).
Methods: A prospective cohort of 1055 patients in SR was enrolled across 12 centers. The main study cohort was divided into two groups: the modeling group (n = 513) and the verification group (n = 542). All patients underwent ESE, which included B-lines, LA volume index (LAVi), and LA strain of the reservoir phase (LASr).
Results: Age, resting and stress LAVi and LASr, and B-lines were identified as a combination of detectors for PAF in both groups. In the entire cohort, aside from resting and stress LAVi and LASr, additional parameters differentiating PAF and non-PAF patients were the presence of systemic hypertension, exercise E/e' > 7, worse right ventricle (RV) contraction during exercise (∆ tricuspid annular plane systolic excursion < 5 mm), a lower left ventricular contractile reserve (< 1.6), and a reduced chronotropic reserve (heart rate reserve < 1.64). The composite score, summing all 9 items, yielded a score of > 4 as the best sensitivity (79%) and specificity (65%).
Conclusion: ESE can complement rest echocardiography in the identification of previous PAF in patients with SR through the evaluation of LA functional reservoir and volume reserve, LV chronotropic, diastolic, and systolic reserve, and RV contractile reserve.
(© 2024. The Author(s).)
Databáze: MEDLINE
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