Improving the diagnosis of heart failure in patients with atrial fibrillation
| Autor: | Bunting, Karina V, Gill, Simrat K, Sitch, Alice, Mehta, Samir, O'Connor, Kieran, Lip, Gregory YH, Kirchhof, Paulus, Strauss, Victoria Y, Rahimi, Kazem, Camm, A John, Stanbury, Mary, Griffith, Michael, Townend, Jonathan N, Gkoutos, Georgios V, Karwath, Andreas, Steeds, Richard P, Kotecha, Dipak, Pe, RAte Control Therapy Evaluation |
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| Přispěvatelé: | group, RAte control Therapy Evaluation in permanent Atrial Fibrillation (RATE-AF) trial |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Systole Coefficient of variation Diastole heart failure Ventricular Function Left Internal medicine Atrial Fibrillation Natriuretic Peptide Brain medicine Humans echocardiography atrial fibrillation In patient Heart Failure and Cardiomyopathies Aged Aged 80 and over Echocardiography Doppler Pulsed Heart Failure Reproducibility Ejection fraction business.industry Reproducibility of Results Stroke Volume Atrial fibrillation medicine.disease Peptide Fragments diastolic Heart failure cardiovascular system Cardiology Female systolic Median Heart Rate Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | HEART Heart Bunting, K V, Gill, S K, Sitch, A, Mehta, S, O'Connor, K, Lip, G Y H, Kirchhof, P, Strauss, V Y, Rahimi, K, Camm, A J, Stanbury, M, Griffith, M, Townend, J N, Gkoutos, G V, Karwath, A, Steeds, R P, Kotecha, D & RAte control Therapy Evaluation in permanent Atrial Fibrillation (RATE-AF) trial group 2021, ' Improving the diagnosis of heart failure in patients with atrial fibrillation ', Heart, vol. 107, no. 11, 318557, pp. 902-908 . https://doi.org/10.1136/heartjnl-2020-318557 |
| ISSN: | 1468-201X |
| Popis: | ObjectiveTo improve the echocardiographic assessment of heart failure in patients with atrial fibrillation (AF) by comparing conventional averaging of consecutive beats with an index-beat approach, whereby measurements are taken after two cycles with similar R-R interval.MethodsTransthoracic echocardiography was performed using a standardised and blinded protocol in patients enrolled in the RATE-AF (RAte control Therapy Evaluation in permanent Atrial Fibrillation) randomised trial. We compared reproducibility of the index-beat and conventional consecutive-beat methods to calculate left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and E/e’ (mitral E wave max/average diastolic tissue Doppler velocity), and assessed intraoperator/interoperator variability, time efficiency and validity against natriuretic peptides.Results160 patients were included, 46% of whom were women, with a median age of 75 years (IQR 69–82) and a median heart rate of 100 beats per minute (IQR 86–112). The index-beat had the lowest within-beat coefficient of variation for LVEF (32%, vs 51% for 5 consecutive beats and 53% for 10 consecutive beats), GLS (26%, vs 43% and 42%) and E/e’ (25%, vs 41% and 41%). Intraoperator (n=50) and interoperator (n=18) reproducibility were both superior for index-beats and this method was quicker to perform (pConclusionsCompared with averaging of multiple beats in patients with AF, the index-beat approach improves reproducibility and saves time without a negative impact on validity, potentially improving the diagnosis and classification of heart failure in patients with AF. |
| Databáze: | OpenAIRE |
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