Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
Background: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. Methods: A cohort of 154...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722001324 |
| _version_ | 1811315207102791680 |
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| author | Ricardo S. Mishima Jonathan P. Ariyaratnam Bradley M. Pitman Varun Malik Mehrdad Emami Olivia McNamee Michael B. Stokes Dennis H. Lau Prashanthan Sanders Adrian D. Elliott |
| author_facet | Ricardo S. Mishima Jonathan P. Ariyaratnam Bradley M. Pitman Varun Malik Mehrdad Emami Olivia McNamee Michael B. Stokes Dennis H. Lau Prashanthan Sanders Adrian D. Elliott |
| author_sort | Ricardo S. Mishima |
| collection | DOAJ |
| description | Background: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. Methods: A cohort of 154 consecutive paroxysmal and persistent AF patients (Age: 62 ± 10, 26% female) referred for exercise stress testing and transthoracic echocardiography were included. We included patients in sinus rhythm with preserved left ventricular ejection fraction who were able to complete a maximal exercise test. Left atrial strain in the reservoir (LASr), booster (LASb) and conduit (LASc) phases were assessed using dedicated software. LA stiffness, emptying fraction (LAEF) and LA to LV ratio were calculated using previously described formulas. Results: CRF was positively associated with LAEF (β = 1.3, 95% CI 0.1–2.3, p = 0.02), reservoir (β = 1.5, 95% CI 0.9–2.1, p < 0.001), booster (β = 0.8, 95% CI 0.4–1.2, p < 0.001) and conduit strain (β = 0.7, 95% CI 0.3–1.1, p = 0.001). We observed an inverse association between CRF and both LA stiffness index (β = −0.02, 95% CI (−0.03)–(−0.01), p < 0.001) and LA to LV ratio (β = −0.03, 95% CI (−0.04)–(−0.01), p < 0.001). Obese patients had significantly higher indexed LA volumes compared to overweight and normal BMI patients. The association between obesity and measures of LA function and stiffness did not reach statistical significance. Conclusion: Among AF patients, higher CRF was independently associated with greater LA function and compliance. Obesity was associated with higher LA volumes yet preserved mechanical function. |
| first_indexed | 2024-04-13T11:26:14Z |
| format | Article |
| id | doaj.art-456a089cc0e84f359cfd186b2544ca19 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-13T11:26:14Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-456a089cc0e84f359cfd186b2544ca192022-12-22T02:48:41ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-10-0142101083Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillationRicardo S. Mishima0Jonathan P. Ariyaratnam1Bradley M. Pitman2Varun Malik3Mehrdad Emami4Olivia McNamee5Michael B. Stokes6Dennis H. Lau7Prashanthan Sanders8Adrian D. Elliott9Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCentre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaCorresponding author at: Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide 5000, Australia.; Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, AustraliaBackground: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. Methods: A cohort of 154 consecutive paroxysmal and persistent AF patients (Age: 62 ± 10, 26% female) referred for exercise stress testing and transthoracic echocardiography were included. We included patients in sinus rhythm with preserved left ventricular ejection fraction who were able to complete a maximal exercise test. Left atrial strain in the reservoir (LASr), booster (LASb) and conduit (LASc) phases were assessed using dedicated software. LA stiffness, emptying fraction (LAEF) and LA to LV ratio were calculated using previously described formulas. Results: CRF was positively associated with LAEF (β = 1.3, 95% CI 0.1–2.3, p = 0.02), reservoir (β = 1.5, 95% CI 0.9–2.1, p < 0.001), booster (β = 0.8, 95% CI 0.4–1.2, p < 0.001) and conduit strain (β = 0.7, 95% CI 0.3–1.1, p = 0.001). We observed an inverse association between CRF and both LA stiffness index (β = −0.02, 95% CI (−0.03)–(−0.01), p < 0.001) and LA to LV ratio (β = −0.03, 95% CI (−0.04)–(−0.01), p < 0.001). Obese patients had significantly higher indexed LA volumes compared to overweight and normal BMI patients. The association between obesity and measures of LA function and stiffness did not reach statistical significance. Conclusion: Among AF patients, higher CRF was independently associated with greater LA function and compliance. Obesity was associated with higher LA volumes yet preserved mechanical function.http://www.sciencedirect.com/science/article/pii/S2352906722001324StrainExerciseArrhythmiaRemodellingLeft atrium |
| spellingShingle | Ricardo S. Mishima Jonathan P. Ariyaratnam Bradley M. Pitman Varun Malik Mehrdad Emami Olivia McNamee Michael B. Stokes Dennis H. Lau Prashanthan Sanders Adrian D. Elliott Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation International Journal of Cardiology: Heart & Vasculature Strain Exercise Arrhythmia Remodelling Left atrium |
| title | Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation |
| title_full | Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation |
| title_fullStr | Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation |
| title_full_unstemmed | Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation |
| title_short | Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation |
| title_sort | cardiorespiratory fitness obesity and left atrial function in patients with atrial fibrillation |
| topic | Strain Exercise Arrhythmia Remodelling Left atrium |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722001324 |
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