Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation
Background: The relationship between pre-ablation left ventricular diastolic dysfunction (LVDD) and prognosis in patients with left ventricular systolic dysfunction (LVSD) undergoing atrial fibrillation (AF) ablation remains unclear. Methods: The prognosis of 173 patients with impaired left ventricu...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722001282 |
| _version_ | 1811280999893434368 |
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| author | Toshiharu Koike Koichiro Ejima Shohei Kataoka Kyoichiro Yazaki Satoshi Higuchi Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara |
| author_facet | Toshiharu Koike Koichiro Ejima Shohei Kataoka Kyoichiro Yazaki Satoshi Higuchi Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara |
| author_sort | Toshiharu Koike |
| collection | DOAJ |
| description | Background: The relationship between pre-ablation left ventricular diastolic dysfunction (LVDD) and prognosis in patients with left ventricular systolic dysfunction (LVSD) undergoing atrial fibrillation (AF) ablation remains unclear. Methods: The prognosis of 173 patients with impaired left ventricular ejection fraction (<50%) who underwent AF ablation was examined. The primary outcome was a composite of all-cause mortality, heart failure (HF) hospitalization, and worsening HF symptoms requiring unplanned outpatient intensification of decongestive therapy. Results: During the follow-up period (median, 3.5 years), the primary outcome after AF ablation occurred in 28 patients (16%). The receiver operating characteristic curve analysis showed that early septal diastolic mitral annular velocity (e′) had a larger area under the curve (0.70) than other LVDD parameters, and optimal cut-off values of LVDD, represented by e′, septal E (early diastolic left ventricular filling velocity)/e′, and peak tricuspid valve regurgitation velocity (TRV), were 5.0 cm/s, 13.2, and 2.5 m/s, respectively. Multivariate analysis revealed that e′ ≤5.0 cm/s (standard hazard ratio [HR], 3.87; 95% confidence interval [CI], 1.73–8.69; p = 0.001), septal E/e′ ≥13.2 (HR, 3.62; 95% CI, 1.60–8.21; p = 0.002), and peak TRV ≥ 2.5 m/s (HR, 2.42; 95% CI, 1.13–5.16; p = 0.02) independently predicted the outcome. Patients with New York Heart Association functional status ≥ III had a 3.3–4.5-fold higher risk of the outcome. Conclusions: LVDD or severe HF symptoms predict poor outcomes in patients with LVSD undergoing AF ablation. Therefore, patients with LVDD or severe HF symptoms should receive more intensive treatment even after AF ablation. |
| first_indexed | 2024-04-13T01:25:57Z |
| format | Article |
| id | doaj.art-edc0b6027d144857a212b82e6dbec21d |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-13T01:25:57Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-edc0b6027d144857a212b82e6dbec21d2022-12-22T03:08:38ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-08-0141101079Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablationToshiharu Koike0Koichiro Ejima1Shohei Kataoka2Kyoichiro Yazaki3Satoshi Higuchi4Miwa Kanai5Daigo Yagishita6Morio Shoda7Nobuhisa Hagiwara8Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; Clinical Research Division for Heart Rhythm Management, Department of Cardiology, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; Corresponding author at: Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; Clinical Research Division for Heart Rhythm Management, Department of Cardiology, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; Clinical Research Division for Heart Rhythm Management, Department of Cardiology, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanDepartment of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, JapanBackground: The relationship between pre-ablation left ventricular diastolic dysfunction (LVDD) and prognosis in patients with left ventricular systolic dysfunction (LVSD) undergoing atrial fibrillation (AF) ablation remains unclear. Methods: The prognosis of 173 patients with impaired left ventricular ejection fraction (<50%) who underwent AF ablation was examined. The primary outcome was a composite of all-cause mortality, heart failure (HF) hospitalization, and worsening HF symptoms requiring unplanned outpatient intensification of decongestive therapy. Results: During the follow-up period (median, 3.5 years), the primary outcome after AF ablation occurred in 28 patients (16%). The receiver operating characteristic curve analysis showed that early septal diastolic mitral annular velocity (e′) had a larger area under the curve (0.70) than other LVDD parameters, and optimal cut-off values of LVDD, represented by e′, septal E (early diastolic left ventricular filling velocity)/e′, and peak tricuspid valve regurgitation velocity (TRV), were 5.0 cm/s, 13.2, and 2.5 m/s, respectively. Multivariate analysis revealed that e′ ≤5.0 cm/s (standard hazard ratio [HR], 3.87; 95% confidence interval [CI], 1.73–8.69; p = 0.001), septal E/e′ ≥13.2 (HR, 3.62; 95% CI, 1.60–8.21; p = 0.002), and peak TRV ≥ 2.5 m/s (HR, 2.42; 95% CI, 1.13–5.16; p = 0.02) independently predicted the outcome. Patients with New York Heart Association functional status ≥ III had a 3.3–4.5-fold higher risk of the outcome. Conclusions: LVDD or severe HF symptoms predict poor outcomes in patients with LVSD undergoing AF ablation. Therefore, patients with LVDD or severe HF symptoms should receive more intensive treatment even after AF ablation.http://www.sciencedirect.com/science/article/pii/S2352906722001282Atrial fibrillationCatheter ablationDiastolic dysfunctionHeart failure |
| spellingShingle | Toshiharu Koike Koichiro Ejima Shohei Kataoka Kyoichiro Yazaki Satoshi Higuchi Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation International Journal of Cardiology: Heart & Vasculature Atrial fibrillation Catheter ablation Diastolic dysfunction Heart failure |
| title | Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| title_full | Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| title_fullStr | Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| title_full_unstemmed | Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| title_short | Prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| title_sort | prognostic significance of diastolic dysfunction in patients with systolic dysfunction undergoing atrial fibrillation ablation |
| topic | Atrial fibrillation Catheter ablation Diastolic dysfunction Heart failure |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722001282 |
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