Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy
Background: Arrhythmia-induced cardiomyopathy (AIC) is characterized by the reversibility of left ventricular (LV) systolic dysfunction (LVSD) after rhythm restoration. This study is a cardiac magnetic resonance tomography substudy of our AIC trial with the purpose to investigate whether left ventri...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/2075-1729/14/3/330 |
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| author | Christian Schach Daniel Lavall Nicola Voßhage Thomas Körtl Christine Meindl Ekrem Ücer Okka Hamer Lars S. Maier Rolf Wachter Samuel Sossalla |
| author_facet | Christian Schach Daniel Lavall Nicola Voßhage Thomas Körtl Christine Meindl Ekrem Ücer Okka Hamer Lars S. Maier Rolf Wachter Samuel Sossalla |
| author_sort | Christian Schach |
| collection | DOAJ |
| description | Background: Arrhythmia-induced cardiomyopathy (AIC) is characterized by the reversibility of left ventricular (LV) systolic dysfunction (LVSD) after rhythm restoration. This study is a cardiac magnetic resonance tomography substudy of our AIC trial with the purpose to investigate whether left ventricular fibrosis affects the time to recovery (TTR) in patients with AIC. Method: Patients with newly diagnosed and otherwise unexplainable LVSD and tachyarrhythmia were prospectively recruited. LV ejection fraction (LVEF) was measured by echocardiography at baseline and 2, 4, and 6 months after rhythm control, and stress markers were assessed. After initial rhythm control, LV fibrosis was assessed through late gadolinium enhancement (LGE). Patients were diagnosed with AIC if their LVEF improved by ≥15% (or ≥10% when LVEF reached ≥50%). Non-responders served as controls (non-AIC). Results: The LGE analysis included 39 patients, 31 of whom recovered (AIC). LV end-systolic diameters decreased and LVEF increased during follow-up. LV LGE content correlated positively with TTR (r = 0.63, <i>p</i> = 0.003), with less LGE favoring faster recovery, and negatively with ΔLVEF (i.e., LVEF at month 2 compared to baseline) as a marker of fast recovery (r = −0.55, <i>p</i> = 0.012), suggesting that LV fibrosis affects the speed of recovery. Conclusion: LV fibrosis correlated positively with the time to recovery in patients with AIC. This correlation may help in the estimation of the recovery period and in the optimization of diagnostic and therapeutic strategies for patients with AIC. |
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| last_indexed | 2024-04-24T18:05:06Z |
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| spelling | doaj.art-a8023d036220410583bd5386c23877192024-03-27T13:51:10ZengMDPI AGLife2075-17292024-03-0114333010.3390/life14030330Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced CardiomyopathyChristian Schach0Daniel Lavall1Nicola Voßhage2Thomas Körtl3Christine Meindl4Ekrem Ücer5Okka Hamer6Lars S. Maier7Rolf Wachter8Samuel Sossalla9Klinik und Poliklinik für Kardiologie, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, GermanyKlinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstrasse 20, 04103 Leipzig, GermanyKlinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstrasse 20, 04103 Leipzig, GermanyMedizinische Klinik I, Justus-Liebig-Universität Gießen, Klinikstr. 33, 35392 Gießen, GermanyKlinik und Poliklinik für Kardiologie, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, GermanyKlinik und Poliklinik für Kardiologie, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, GermanyInstitut für Röntgendiagnostik, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, GermanyKlinik und Poliklinik für Kardiologie, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, GermanyKlinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstrasse 20, 04103 Leipzig, GermanyKlinik und Poliklinik für Kardiologie, Universitäres Herzzentrum Regensburg, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, GermanyBackground: Arrhythmia-induced cardiomyopathy (AIC) is characterized by the reversibility of left ventricular (LV) systolic dysfunction (LVSD) after rhythm restoration. This study is a cardiac magnetic resonance tomography substudy of our AIC trial with the purpose to investigate whether left ventricular fibrosis affects the time to recovery (TTR) in patients with AIC. Method: Patients with newly diagnosed and otherwise unexplainable LVSD and tachyarrhythmia were prospectively recruited. LV ejection fraction (LVEF) was measured by echocardiography at baseline and 2, 4, and 6 months after rhythm control, and stress markers were assessed. After initial rhythm control, LV fibrosis was assessed through late gadolinium enhancement (LGE). Patients were diagnosed with AIC if their LVEF improved by ≥15% (or ≥10% when LVEF reached ≥50%). Non-responders served as controls (non-AIC). Results: The LGE analysis included 39 patients, 31 of whom recovered (AIC). LV end-systolic diameters decreased and LVEF increased during follow-up. LV LGE content correlated positively with TTR (r = 0.63, <i>p</i> = 0.003), with less LGE favoring faster recovery, and negatively with ΔLVEF (i.e., LVEF at month 2 compared to baseline) as a marker of fast recovery (r = −0.55, <i>p</i> = 0.012), suggesting that LV fibrosis affects the speed of recovery. Conclusion: LV fibrosis correlated positively with the time to recovery in patients with AIC. This correlation may help in the estimation of the recovery period and in the optimization of diagnostic and therapeutic strategies for patients with AIC.https://www.mdpi.com/2075-1729/14/3/330atrial fibrillationtachymyopathyheart failureleft ventricular dysfunctionrhythm controlcardiac MRI |
| spellingShingle | Christian Schach Daniel Lavall Nicola Voßhage Thomas Körtl Christine Meindl Ekrem Ücer Okka Hamer Lars S. Maier Rolf Wachter Samuel Sossalla Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy Life atrial fibrillation tachymyopathy heart failure left ventricular dysfunction rhythm control cardiac MRI |
| title | Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy |
| title_full | Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy |
| title_fullStr | Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy |
| title_full_unstemmed | Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy |
| title_short | Time to Recovery from Systolic Dysfunction Correlates with Left Ventricular Fibrosis in Arrhythmia-Induced Cardiomyopathy |
| title_sort | time to recovery from systolic dysfunction correlates with left ventricular fibrosis in arrhythmia induced cardiomyopathy |
| topic | atrial fibrillation tachymyopathy heart failure left ventricular dysfunction rhythm control cardiac MRI |
| url | https://www.mdpi.com/2075-1729/14/3/330 |
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