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Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation.

Lim HE, Na JO, Im SI, Choi CU, Kim SH, Kim JW, Kim EJ, Han SW, Rha SW, Park CG, Seo HS, Oh DJ, Hwang C - Korean J. Intern. Med. (2015)

Bottom Line: IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019).Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia.Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.

ABSTRACT

Background/aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling.

Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm.

Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEFtotal; r = -0.213, p = 0.030), and active LAEF (LAEFactive; r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence.

Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

No MeSH data available.


Related in: MedlinePlus

Mean left atrial voltage (LAVOL) and interatrial septal (IAS) thickness according to CHADS2 score and CHA2DS2-VASc score. (A, C) There were no statistically significant differences in mean LAVOL or IAS thickness according to CHADS2 score. (B, D) However, mean LAVOL was significantly lower and IAS thickness was significantly higher in high-risk CHA2DS2-VASc level (≥ 2).
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f3-kjim-30-6-808: Mean left atrial voltage (LAVOL) and interatrial septal (IAS) thickness according to CHADS2 score and CHA2DS2-VASc score. (A, C) There were no statistically significant differences in mean LAVOL or IAS thickness according to CHADS2 score. (B, D) However, mean LAVOL was significantly lower and IAS thickness was significantly higher in high-risk CHA2DS2-VASc level (≥ 2).

Mentions: Mean LAVOL and septal LAVOL showed negative correlations with IAS thickness (r = –0.537, p < 0.001; r = –0.330, p = 0.001, respectively). In addition, mean LAVOL showed positive correlations with LAEFtotal and LAEFactive (r = 0.292, p = 0.003; r = 0.283, p = 0.005, respectively). IAS thickness was associated with LAVs and LAEFs (Fig. 2). It was also correlated with CHA2DS2-VASc score (r = 0.348, p < 0.001) and CHADS2 score (r = 0.208, p = 0.034). Fig. 3 shows a comparison of mean LAVOL and IAS thickness among three groups according to CHADS2 score (0, n = 52; 1, n = 36; ≥ 2, n = 16), and CHA2DS2-VASc score (0, n = 35; 1, n = 34; ≥ 2, n = 35). Mean LAVOL was much lower in the high-risk group than in the other groups according to CHADS2 score (p = 0.090) (Fig. 3A) and CHA2DS2-VASc score (p = 0.001) (Fig. 3B). IAS thickness was much greater in the high-risk group than the other groups according to CHADS2 score (p = 0.056) (Fig. 3C) and CHA2DS2-VASc score (p = 0.019) (Fig. 3D).


Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation.

Lim HE, Na JO, Im SI, Choi CU, Kim SH, Kim JW, Kim EJ, Han SW, Rha SW, Park CG, Seo HS, Oh DJ, Hwang C - Korean J. Intern. Med. (2015)

Mean left atrial voltage (LAVOL) and interatrial septal (IAS) thickness according to CHADS2 score and CHA2DS2-VASc score. (A, C) There were no statistically significant differences in mean LAVOL or IAS thickness according to CHADS2 score. (B, D) However, mean LAVOL was significantly lower and IAS thickness was significantly higher in high-risk CHA2DS2-VASc level (≥ 2).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4642010&req=5

f3-kjim-30-6-808: Mean left atrial voltage (LAVOL) and interatrial septal (IAS) thickness according to CHADS2 score and CHA2DS2-VASc score. (A, C) There were no statistically significant differences in mean LAVOL or IAS thickness according to CHADS2 score. (B, D) However, mean LAVOL was significantly lower and IAS thickness was significantly higher in high-risk CHA2DS2-VASc level (≥ 2).
Mentions: Mean LAVOL and septal LAVOL showed negative correlations with IAS thickness (r = –0.537, p < 0.001; r = –0.330, p = 0.001, respectively). In addition, mean LAVOL showed positive correlations with LAEFtotal and LAEFactive (r = 0.292, p = 0.003; r = 0.283, p = 0.005, respectively). IAS thickness was associated with LAVs and LAEFs (Fig. 2). It was also correlated with CHA2DS2-VASc score (r = 0.348, p < 0.001) and CHADS2 score (r = 0.208, p = 0.034). Fig. 3 shows a comparison of mean LAVOL and IAS thickness among three groups according to CHADS2 score (0, n = 52; 1, n = 36; ≥ 2, n = 16), and CHA2DS2-VASc score (0, n = 35; 1, n = 34; ≥ 2, n = 35). Mean LAVOL was much lower in the high-risk group than in the other groups according to CHADS2 score (p = 0.090) (Fig. 3A) and CHA2DS2-VASc score (p = 0.001) (Fig. 3B). IAS thickness was much greater in the high-risk group than the other groups according to CHADS2 score (p = 0.056) (Fig. 3C) and CHA2DS2-VASc score (p = 0.019) (Fig. 3D).

Bottom Line: IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019).Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia.Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.

ABSTRACT

Background/aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling.

Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm.

Results: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEFtotal; r = -0.213, p = 0.030), and active LAEF (LAEFactive; r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence.

Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

No MeSH data available.


Related in: MedlinePlus