Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter
Background Left ventricular (LV) systolic dysfunction is reversible in some patients once the arrhythmia is controlled. However, identifying this arrhythmia‐induced cardiomyopathy among patients with LV systolic dysfunction is challenging. We explored the factors predicting the reversibility of the...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015126 |
| _version_ | 1811332154209075200 |
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| author | Daisetsu Aoyama Shinsuke Miyazaki Kanae Hasegawa Kenichi Kaseno Eri Ishikawa Moe Mukai Minoru Nodera Kosuke Miyahara Akira Matsui Yuichiro Shiomi Naoto Tama Hiroyuki Ikeda Yoshitomo Fukuoka Tetsuji Morishita Kentaro Ishida Hiroyasu Uzui Hiroshi Tada |
| author_facet | Daisetsu Aoyama Shinsuke Miyazaki Kanae Hasegawa Kenichi Kaseno Eri Ishikawa Moe Mukai Minoru Nodera Kosuke Miyahara Akira Matsui Yuichiro Shiomi Naoto Tama Hiroyuki Ikeda Yoshitomo Fukuoka Tetsuji Morishita Kentaro Ishida Hiroyasu Uzui Hiroshi Tada |
| author_sort | Daisetsu Aoyama |
| collection | DOAJ |
| description | Background Left ventricular (LV) systolic dysfunction is reversible in some patients once the arrhythmia is controlled. However, identifying this arrhythmia‐induced cardiomyopathy among patients with LV systolic dysfunction is challenging. We explored the factors predicting the reversibility of the LV ejection fraction (LVEF) after catheter ablation of atrial fibrillation and/or atrial flutter in patients with LV systolic dysfunction. Methods and Results Forty patients with a reduced LVEF (LVEF <50%; 66.2±10.7 years; 32 men) who underwent atrial fibrillation/atrial flutter ablation were included. Transthoracic echocardiography was performed before and during the early (<4 days) and late phases (>3 months) after the ablation. Responders were defined as having a normalized LVEF (≥50%) during the late phase after the ablation. The LVEF improved from 39.8±8.8 to 50.9±10.9% at 1.2±0.6 days after the procedure, and to 56.2±12.2% at 9.6±8.0 months after the procedure (both for P<0.001). Thirty (75.0%) patients were responders. The preprocedural echocardiographic parameters were comparable between the responders and nonresponders. In the multivariate analysis, the preprocedural high‐sensitivity troponin T was the only independent predictor of the recovery of the LV dysfunction during the late phase after ablation (odds ratio, 1.17; 95% CI, 1.06–1.33; P=0.001), and a level of ≤12 pg/mL predicted recovery of the LV dysfunction with a high accuracy (sensitivity, 90.0%; specificity, 76.7%; positive predictive value, 56.3%; and negative predictive value, 95.8%). Conclusions Preprocedural high‐sensitivity troponin T levels might be a simple and useful parameter for predicting the reversibility of the LV systolic dysfunction after atrial fibrillation/atrial flutter ablation in patients with a reduced LVEF. |
| first_indexed | 2024-04-13T16:31:25Z |
| format | Article |
| id | doaj.art-71e0bbfde15c4a43b56fcb343a90180d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:31:25Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-71e0bbfde15c4a43b56fcb343a90180d2022-12-22T02:39:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-04-019710.1161/JAHA.119.015126Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/FlutterDaisetsu Aoyama0Shinsuke Miyazaki1Kanae Hasegawa2Kenichi Kaseno3Eri Ishikawa4Moe Mukai5Minoru Nodera6Kosuke Miyahara7Akira Matsui8Yuichiro Shiomi9Naoto Tama10Hiroyuki Ikeda11Yoshitomo Fukuoka12Tetsuji Morishita13Kentaro Ishida14Hiroyasu Uzui15Hiroshi Tada16Department of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanDepartment of Cardiovascular Medicine Faculty of Medical Sciences University of Fukui JapanBackground Left ventricular (LV) systolic dysfunction is reversible in some patients once the arrhythmia is controlled. However, identifying this arrhythmia‐induced cardiomyopathy among patients with LV systolic dysfunction is challenging. We explored the factors predicting the reversibility of the LV ejection fraction (LVEF) after catheter ablation of atrial fibrillation and/or atrial flutter in patients with LV systolic dysfunction. Methods and Results Forty patients with a reduced LVEF (LVEF <50%; 66.2±10.7 years; 32 men) who underwent atrial fibrillation/atrial flutter ablation were included. Transthoracic echocardiography was performed before and during the early (<4 days) and late phases (>3 months) after the ablation. Responders were defined as having a normalized LVEF (≥50%) during the late phase after the ablation. The LVEF improved from 39.8±8.8 to 50.9±10.9% at 1.2±0.6 days after the procedure, and to 56.2±12.2% at 9.6±8.0 months after the procedure (both for P<0.001). Thirty (75.0%) patients were responders. The preprocedural echocardiographic parameters were comparable between the responders and nonresponders. In the multivariate analysis, the preprocedural high‐sensitivity troponin T was the only independent predictor of the recovery of the LV dysfunction during the late phase after ablation (odds ratio, 1.17; 95% CI, 1.06–1.33; P=0.001), and a level of ≤12 pg/mL predicted recovery of the LV dysfunction with a high accuracy (sensitivity, 90.0%; specificity, 76.7%; positive predictive value, 56.3%; and negative predictive value, 95.8%). Conclusions Preprocedural high‐sensitivity troponin T levels might be a simple and useful parameter for predicting the reversibility of the LV systolic dysfunction after atrial fibrillation/atrial flutter ablation in patients with a reduced LVEF.https://www.ahajournals.org/doi/10.1161/JAHA.119.015126arrhythmia‐induced cardiomyopathyatrial fibrillationcatheter ablationleft ventricular dysfunctiontroponin T |
| spellingShingle | Daisetsu Aoyama Shinsuke Miyazaki Kanae Hasegawa Kenichi Kaseno Eri Ishikawa Moe Mukai Minoru Nodera Kosuke Miyahara Akira Matsui Yuichiro Shiomi Naoto Tama Hiroyuki Ikeda Yoshitomo Fukuoka Tetsuji Morishita Kentaro Ishida Hiroyasu Uzui Hiroshi Tada Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arrhythmia‐induced cardiomyopathy atrial fibrillation catheter ablation left ventricular dysfunction troponin T |
| title | Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter |
| title_full | Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter |
| title_fullStr | Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter |
| title_full_unstemmed | Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter |
| title_short | Preprocedural Troponin T Levels Predict the Improvement in the Left Ventricular Ejection Fraction After Catheter Ablation of Atrial Fibrillation/Flutter |
| title_sort | preprocedural troponin t levels predict the improvement in the left ventricular ejection fraction after catheter ablation of atrial fibrillation flutter |
| topic | arrhythmia‐induced cardiomyopathy atrial fibrillation catheter ablation left ventricular dysfunction troponin T |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015126 |
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