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Disturbed Left Atrial Function is Associated with Paroxysmal Atrial Fibrillation in Hypertension.

Tenekecioglu E, Agca FV, Ozluk OA, Karaagac K, Demir S, Peker T, Kuzeytemiz M, Senturk M, Yilmaz M - Arq. Bras. Cardiol. (2014)

Bottom Line: LAAEF was significantly decreased in hypertensive group with PAF as compared to hypertensive group without PAF (p=0.020).A' was decreased in the hypertensive group with PAF when compared to those without PAF (p = 0.044).Longer hypertensive period is associated with PAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Bursa Yuksek Ihtisas Education and Resarch Hospital, Bursa, Turkey.

ABSTRACT

Background: Hypertension is the most prevalent and modifiable risk factor for atrial fibrillation. The pressure overload in the left atrium induces pathophysiological changes leading to alterations in contractile function and electrical properties.

Objective: In this study our aim was to assess left atrial function in hypertensive patients to determine the association between left atrial function with paroxysmal atrial fibrillation (PAF).

Method: We studied 57 hypertensive patients (age: 53 ± 4 years; left ventricular ejection fraction: 76 ± 6.7%), including 30 consecutive patients with PAF and 30 age-matched control subjects. Left atrial (LA) volumes were measured using the modified Simpson's biplane method. Three types of LA volume were determined: maximal LA(LAVmax), preatrial contraction LA(LAVpreA) and minimal LA volume(LAVmin). LA emptying functions were calculated. LA total emptying volume = LAVmax-LAVmin and the LA total EF = (LAVmax-LAVmin )/LAVmax, LA passive emptying volume = LAVmax- LAVpreA and the LA passive EF = (LAVmax-LAVpreA)/LAVmax, LA active emptying volume = LAVpreA-LAVmin and LA active EF = (LAVpreA-LAVmin )/LAVpreA.

Results: The hypertensive period is longer in hypertensive group with PAF. LAVmax significantly increased in hypertensive group with PAF when compared to hypertensive group without PAF (p=0.010). LAAEF was significantly decreased in hypertensive group with PAF as compared to hypertensive group without PAF (p=0.020). A' was decreased in the hypertensive group with PAF when compared to those without PAF (p = 0.044).

Conclusion: Increased LA volume and impaired LA active emptying function was associated with PAF in untreated hypertensive patients. Longer hypertensive period is associated with PAF.

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Related in: MedlinePlus

ROC curve analysis for LAAEF in predicting PAF (sen: 74%; spe: 55%; AUC:0.679).
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f02: ROC curve analysis for LAAEF in predicting PAF (sen: 74%; spe: 55%; AUC:0.679).

Mentions: Using ROC curve analysis, LAVImax yielded an area under the curve of 70% (p < 0.05)for prediction of PAF attacks. When the LAVImax (> 20.9 mL/m2) was used ascutoff to predict PAF in patients with HT and PAF could be identified with a sensitivityof 80% and a specificity of 51%. The sensitivity and specificity for LAAEF (≤ 0.45) topredict PAF were 74% and 55% respectively. The area under the curve was 68% (p <0.05). The sensitivity and specificity for A' (≤0.11m/s) to predict PAF were 67% and 45%respectively. The area under the curve was 65% (p < 0.05) (Figures 1, 2 and 3). In multivariate logistic regression analyses toevaluate the influence of PAF and hypertension duration on left atrial volumes andfunctions, we found that while PAF has influence on LAVImax, LAVImin, LAVpreA and LAAEF,hypertension duration has influence on LAAEF only (Table 3).


Disturbed Left Atrial Function is Associated with Paroxysmal Atrial Fibrillation in Hypertension.

Tenekecioglu E, Agca FV, Ozluk OA, Karaagac K, Demir S, Peker T, Kuzeytemiz M, Senturk M, Yilmaz M - Arq. Bras. Cardiol. (2014)

ROC curve analysis for LAAEF in predicting PAF (sen: 74%; spe: 55%; AUC:0.679).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987319&req=5

f02: ROC curve analysis for LAAEF in predicting PAF (sen: 74%; spe: 55%; AUC:0.679).
Mentions: Using ROC curve analysis, LAVImax yielded an area under the curve of 70% (p < 0.05)for prediction of PAF attacks. When the LAVImax (> 20.9 mL/m2) was used ascutoff to predict PAF in patients with HT and PAF could be identified with a sensitivityof 80% and a specificity of 51%. The sensitivity and specificity for LAAEF (≤ 0.45) topredict PAF were 74% and 55% respectively. The area under the curve was 68% (p <0.05). The sensitivity and specificity for A' (≤0.11m/s) to predict PAF were 67% and 45%respectively. The area under the curve was 65% (p < 0.05) (Figures 1, 2 and 3). In multivariate logistic regression analyses toevaluate the influence of PAF and hypertension duration on left atrial volumes andfunctions, we found that while PAF has influence on LAVImax, LAVImin, LAVpreA and LAAEF,hypertension duration has influence on LAAEF only (Table 3).

Bottom Line: LAAEF was significantly decreased in hypertensive group with PAF as compared to hypertensive group without PAF (p=0.020).A' was decreased in the hypertensive group with PAF when compared to those without PAF (p = 0.044).Longer hypertensive period is associated with PAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Bursa Yuksek Ihtisas Education and Resarch Hospital, Bursa, Turkey.

ABSTRACT

Background: Hypertension is the most prevalent and modifiable risk factor for atrial fibrillation. The pressure overload in the left atrium induces pathophysiological changes leading to alterations in contractile function and electrical properties.

Objective: In this study our aim was to assess left atrial function in hypertensive patients to determine the association between left atrial function with paroxysmal atrial fibrillation (PAF).

Method: We studied 57 hypertensive patients (age: 53 ± 4 years; left ventricular ejection fraction: 76 ± 6.7%), including 30 consecutive patients with PAF and 30 age-matched control subjects. Left atrial (LA) volumes were measured using the modified Simpson's biplane method. Three types of LA volume were determined: maximal LA(LAVmax), preatrial contraction LA(LAVpreA) and minimal LA volume(LAVmin). LA emptying functions were calculated. LA total emptying volume = LAVmax-LAVmin and the LA total EF = (LAVmax-LAVmin )/LAVmax, LA passive emptying volume = LAVmax- LAVpreA and the LA passive EF = (LAVmax-LAVpreA)/LAVmax, LA active emptying volume = LAVpreA-LAVmin and LA active EF = (LAVpreA-LAVmin )/LAVpreA.

Results: The hypertensive period is longer in hypertensive group with PAF. LAVmax significantly increased in hypertensive group with PAF when compared to hypertensive group without PAF (p=0.010). LAAEF was significantly decreased in hypertensive group with PAF as compared to hypertensive group without PAF (p=0.020). A' was decreased in the hypertensive group with PAF when compared to those without PAF (p = 0.044).

Conclusion: Increased LA volume and impaired LA active emptying function was associated with PAF in untreated hypertensive patients. Longer hypertensive period is associated with PAF.

Show MeSH
Related in: MedlinePlus