Abstract
Background and AimsAtrial fibrillation (AF) is the most frequent arrhythmia in elderly patients. Aims of this study were to evaluate the predictors of arterial stiffness after external cardioversion (ECV) of AF and to establish whether a link exists between vascular properties and left atrial diameter (LAD).MethodsWe studied 33 patients (age 73 ± 12 years). After 5 h from ECV of persistent AF, an echocardiogram was recorded and arterial stiffness was evaluated with cardio-ankle vascular stiffness index (CAVI).ResultsIn multivariate analysis (R = 0.538, p = 0.006), CAVI (mean 9.60 ± 1.63) increased with age (p = 0.018) and with an AF length ≤3 months (p = 0.022). LAD was significantly related to CAVI (p = 0.007) even after adjustment for interventricular septum thickness (p = 0.018) (R = 0.574, p = 0.002).ConclusionsIn patients with AF, immediately after ECV, arterial stiffness is associated with age and AF length, and could represent an important factor for left atrium remodeling and, therefore, for AF maintenance.
Highlights
Atrial fibrillation (AF) is the most common sustained arrhythmia in the elderly [1]; its prevalence is justified by cardiovascular aging and the age-related increase of comorbidity [1,2,3]
A multivariate model demonstrated that both interventricular septum thickness (b = 1.82 ± 0.73, 95 % CI = 0.34–3.30, p = 0.018) and cardio-ankle vascular stiffness index (CAVI) (b = 1.92 ± 0.66, 95 % CI = 0.56–3.27, p = 0.007) were predictors of left atrial diameter (LAD) (Fig. 1). The results of this preliminary study confirm the existence of a direct relationship between CAVI and age, in patients treated with external cardioversion (ECV) for persistent AF
Reiffel [7] found that Arterial stiffness (AS) and left ventricular (LV) hypertrophy did not predict the risk of AF in hypertensive patients and concluded that the arrhythmia is generated by complex mechanisms induced by atrial hypertension
Summary
Atrial fibrillation (AF) is the most common sustained arrhythmia in the elderly [1]; its prevalence is justified by cardiovascular aging and the age-related increase of comorbidity [1,2,3]. The endpoint of this study was to define the clinical determinants of AS in subjects with persistent AF immediately after external cardioversion (ECV). We assessed the existence of a link between left atrium (LA) diameter (LAD) and AS. Aims of this study were to evaluate the predictors of arterial stiffness after external cardioversion (ECV) of AF and to establish whether a link exists between vascular properties and left atrial diameter (LAD). Conclusions In patients with AF, immediately after ECV, arterial stiffness is associated with age and AF length, and could represent an important factor for left atrium remodeling and, for AF maintenance
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