Usefulness of Preprocedural Left Ventricular End-Systolic Volume Index and Early Diastolic Mitral Annular Velocity in Predicting Improvement in Left Ventricular Ejection Fraction Following Atrial Fibrillation Ablation in Patients With Impaired Left Ventricular Systolic Function - 10/02/20
, Miwa Kanai, MD a, Shohei Kataoka, MD a, Satoshi Higuchi, MD a, Daigo Yagishita, MD a, Morio Shoda, MD, PhD a, b, Nobuhisa Hagiwara, MD, PhD aHighlights |
• | LVEF improvement was associated with good prognosis during long-term follow-up. |
• | The echocardiographic parameters e′ and preprocedural LVESVI could moderately predict LVEF improvement. |
• | Lower LVESVI and higher e′ could independently predict LVEF improvement. |
Résumé |
Catheter ablation of atrial fibrillation (AF) is known to facilitate reverse remodeling of the left ventricle. However, factors that can improve the left ventricular (LV) systolic function remain elusive. In this study, we investigated factors related to LV ejection fraction (LVEF) improvement following AF ablation in patients with systolic dysfunction. A total of 140 patients with impaired LVEF (<50%) who underwent AF ablation were retrospectively evaluated. The primary outcome was LVEF improvement. A total of 68, 9, and 15 patients achieved LVEF improvement at 3, 6, and 12 months after AF ablation, respectively. Five patients achieved late LVEF improvement. The overall LVEF improvement rate was 69%. In the receiver operating characteristic curve analysis, the LV end-systolic volume (LVESVI) and early diastolic mitral annular velocity (e′) had larger areas under the curve (0.79 and 0.75, respectively) than other echocardiographic parameters, and the most optimal cutoff values of LVESVI and e′ were 49.8 ml/m2 and 5.4 cm/s, respectively. Moreover, preprocedural LVESVI ≤49.8 ml/m2 and e′ ≥5.4 independently predicted the outcome after adjusting for confounders (hazard ratio 1.74; 95% confidence interval 1.06 to 2.95; p = 0.03; hazard ratio, 1.99; 95% confidence interval 1.13 to 3.64; p = 0.01). LVEF improvement was achieved in 69% of patients who underwent AF ablation, including 4% with late improvement. Lower LVESVI and higher e′ could independently predict LVEF improvement.
Le texte complet de cet article est disponible en PDF.Plan
| Author statement: Kyoichiro Yazaki: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Writing – Original draft, Visualization. Koichiro Ejima: Conceptualization, Methodology, Validation, Resources, Data Curation, Writing – Review and editing, Supervision, Project administration. Miwa Kanai: Resources, Validation. Shohei Kataoka: Resources, Data curation, Validation. Satoshi Higuchi: Resources, Data curation, Validation. Daigo Yagishita: Resources, Data curation, Validation. Morio Shoda: Methodology, Validation, Supervision, Funding acquisition. Nobuhisa Hagiwara: Validation, Supervision. |
Vol 125 - N° 5
P. 759-766 - mars 2020 Retour au numéro
Article précédent
- Endothelial Dysfunction, Fibrinolytic Activity, and Coagulation Activity in Patients With Atrial Fibrillation According to Type II Diabetes Mellitus Status
- Giuseppe Patti, Elisabetta Cerchiara, Edoardo Bressi, Barbara Giannetti, Alessia Delli Veneri, Germano Di Sciascio, Giuseppe Avvisati, Raffaele De Caterina
- Comparison of Holter With Zio Patch Electrocardiography Monitoring in Children
- Meena Bolourchi, Eric S. Silver, David Muwanga, Esteban Mendez, Leonardo Liberman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?