Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility
Background Atrial fibrillation (AF) progression is closely related to heart failure occurrence, and catheter ablation carries a beneficial effect for heart failure prevention. Recently, particular attention has been given to left atrial (LA) function and functional reserve in the pathogenesis linkin...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032215 |
| _version_ | 1797229320596357120 |
|---|---|
| author | Kazutoshi Hirose Koki Nakanishi Masao Daimon Kentaro Iwama Yuriko Yoshida Yasuhiro Mukai Yuko Yamamoto Tomoko Nakao Tsukasa Oshima Takumi Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Eriko Hasumi Katsuhito Fujiu Hiroyuki Morita Issei Komuro |
| author_facet | Kazutoshi Hirose Koki Nakanishi Masao Daimon Kentaro Iwama Yuriko Yoshida Yasuhiro Mukai Yuko Yamamoto Tomoko Nakao Tsukasa Oshima Takumi Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Eriko Hasumi Katsuhito Fujiu Hiroyuki Morita Issei Komuro |
| author_sort | Kazutoshi Hirose |
| collection | DOAJ |
| description | Background Atrial fibrillation (AF) progression is closely related to heart failure occurrence, and catheter ablation carries a beneficial effect for heart failure prevention. Recently, particular attention has been given to left atrial (LA) function and functional reserve in the pathogenesis linking AF and heart failure, although its significance and reversibility is not well studied. Methods and Results We prospectively investigated 164 patients with AF with normal left ventricular systolic function and free from heart failure who underwent first catheter ablation and pre‐/postprocedural echocardiography. Conventional and speckle‐tracking echocardiography were performed at rest and during passive leg lifting to assess LA size, LA reservoir strain (LARS), and functional reserve calculated as passive leg lifting‐LARS – rest‐LARS. Patients were categorized into 3 AF subtypes: paroxysmal AF (N=95), persistent AF (PeAF; N=50), and long‐standing persistent AF (LS‐PeAF; N=19). The PeAF and LS‐PeAF groups had larger LA size and reduced LARS compared with the paroxysmal AF group (all P<0.05). LA functional reserve was significantly impaired in the LS‐PeAF group (P=0.003). In multivariable analysis, LS‐PeAF and advanced age were significantly associated with impaired LA functional reserve. Among 149 patients with sinus rhythm 1 to 2 days after catheter ablation, LARS was significantly improved in both PeAF and LS‐PeAF groups but was still lower than that in the paroxysmal AF group. Sinus rhythm restoration also led to amelioration of LA functional reserve in patients with LS‐PeAF. Conclusions AF progression was related to impaired LARS and LA functional reserve, and restoration of sinus rhythm might contribute to early LA reverse remodeling. |
| first_indexed | 2024-03-08T13:50:20Z |
| format | Article |
| id | doaj.art-73fba12d00e54eaa85018524b5d7eed9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:43Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-73fba12d00e54eaa85018524b5d7eed92024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.032215Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its ReversibilityKazutoshi Hirose0Koki Nakanishi1Masao Daimon2Kentaro Iwama3Yuriko Yoshida4Yasuhiro Mukai5Yuko Yamamoto6Tomoko Nakao7Tsukasa Oshima8Takumi Matsubara9Yu Shimizu10Gaku Oguri11Toshiya Kojima12Eriko Hasumi13Katsuhito Fujiu14Hiroyuki Morita15Issei Komuro16Department of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanDepartment of Cardiovascular Medicine University of Tokyo JapanBackground Atrial fibrillation (AF) progression is closely related to heart failure occurrence, and catheter ablation carries a beneficial effect for heart failure prevention. Recently, particular attention has been given to left atrial (LA) function and functional reserve in the pathogenesis linking AF and heart failure, although its significance and reversibility is not well studied. Methods and Results We prospectively investigated 164 patients with AF with normal left ventricular systolic function and free from heart failure who underwent first catheter ablation and pre‐/postprocedural echocardiography. Conventional and speckle‐tracking echocardiography were performed at rest and during passive leg lifting to assess LA size, LA reservoir strain (LARS), and functional reserve calculated as passive leg lifting‐LARS – rest‐LARS. Patients were categorized into 3 AF subtypes: paroxysmal AF (N=95), persistent AF (PeAF; N=50), and long‐standing persistent AF (LS‐PeAF; N=19). The PeAF and LS‐PeAF groups had larger LA size and reduced LARS compared with the paroxysmal AF group (all P<0.05). LA functional reserve was significantly impaired in the LS‐PeAF group (P=0.003). In multivariable analysis, LS‐PeAF and advanced age were significantly associated with impaired LA functional reserve. Among 149 patients with sinus rhythm 1 to 2 days after catheter ablation, LARS was significantly improved in both PeAF and LS‐PeAF groups but was still lower than that in the paroxysmal AF group. Sinus rhythm restoration also led to amelioration of LA functional reserve in patients with LS‐PeAF. Conclusions AF progression was related to impaired LARS and LA functional reserve, and restoration of sinus rhythm might contribute to early LA reverse remodeling.https://www.ahajournals.org/doi/10.1161/JAHA.123.032215atrial fibrillationleft atrial functional reserveleft atrial reservoir strainspeckle‐tracking echocardiography |
| spellingShingle | Kazutoshi Hirose Koki Nakanishi Masao Daimon Kentaro Iwama Yuriko Yoshida Yasuhiro Mukai Yuko Yamamoto Tomoko Nakao Tsukasa Oshima Takumi Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Eriko Hasumi Katsuhito Fujiu Hiroyuki Morita Issei Komuro Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation left atrial functional reserve left atrial reservoir strain speckle‐tracking echocardiography |
| title | Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility |
| title_full | Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility |
| title_fullStr | Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility |
| title_full_unstemmed | Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility |
| title_short | Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility |
| title_sort | association of atrial fibrillation progression with left atrial functional reserve and its reversibility |
| topic | atrial fibrillation left atrial functional reserve left atrial reservoir strain speckle‐tracking echocardiography |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032215 |
| work_keys_str_mv | AT kazutoshihirose associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT kokinakanishi associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT masaodaimon associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT kentaroiwama associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT yurikoyoshida associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT yasuhiromukai associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT yukoyamamoto associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT tomokonakao associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT tsukasaoshima associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT takumimatsubara associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT yushimizu associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT gakuoguri associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT toshiyakojima associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT erikohasumi associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT katsuhitofujiu associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT hiroyukimorita associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility AT isseikomuro associationofatrialfibrillationprogressionwithleftatrialfunctionalreserveanditsreversibility |