Association between atrial fibrillation, atrial enlargement, and left ventricular geometric remodeling

Yuta Seko,Eisaku Nakane,Toshiaki Izumi,Tetsuya Haruna,Shoichi Miyamoto,Moriaki Inoko,Takao Kato

doi:10.1038/s41598-018-24875-1

Yuta Seko, Eisaku Nakane + Show 5 more

Open Access

https://doi.org/10.1038/s41598-018-24875-1

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Journal: Scientific Reports	Publication Date: Apr 23, 2018
Citations: 92	License type: open-access

Affiliation: Kitano Hospital, Kyoto University

Abstract

This study investigated the relationship between atrial fibrillation (AF) and left ventricular (LV) geometric patterns in a hospital-based population in Japan. We retrospectively analyzed 4444 patients who had undergone simultaneous scheduled transthoracic echocardiography (TTE) and electrocardiography during 2013. A total of 430 patients who had findings of previous myocardial infarctions (n = 419) and without the data on body surface area (n = 11) were excluded from the study. We calculated the LV mass index (LVMI) and relative wall (RWT) and categorized 4014 patients into four groups as follows: normal geometry (n = 3046); concentric remodeling (normal LVMI and high RWT, n = 437); concentric hypertrophy (high LVMI and high RWT, n = 149); and eccentric remodeling (high LVMI and normal RWT, n = 382). The mean left atrial volume indices (LAVI) were 22.5, 23.8, 33.3, and 37.0 mm/m2 in patients with normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, respectively. The mean LV ejection fractions (LVEF) were 62.7, 62.6, 60.8, and 53.8%, respectively, whereas the prevalence of AF was 10.4%, 10.5%, 14.8%, and 16.8% in patients with normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, respectively. In conclusion, the prevalence of AF was increasing according to LV geometric remodeling patterns in association with LA size and LVEF.

Highlights

Left ventricular (LV) hypertrophy (LVH) may be considered a compensatory effect since increasing left ventricular (LV) wall thickness reduces LV wall stress[1]
Concentric LVH has a high mortality risk with preserved ejection fraction (EF)[6,7] or a high mortality risk in patients without regression of abnormal LV geometry[8]; other studies have reported that relative wall thickness has less impact on prognosis in patients with coronary heart disease[3]
In this study, we investigated the association between LV geometric patterns, Left atrial (LA) enlargement, and atrial fibrillation (AF)

Summary

Introduction

Left ventricular (LV) hypertrophy (LVH) may be considered a compensatory effect since increasing LV wall thickness reduces LV wall stress[1]. Patterns of LVH and geometric remodeling have previously been investigated extensively in patients with hypertension and valvular heart diseases[4,5]. Concentric LVH has a high mortality risk with preserved ejection fraction (EF)[6,7] or a high mortality risk in patients without regression of abnormal LV geometry[8]; other studies have reported that relative wall thickness has less impact on prognosis in patients with coronary heart disease[3]. LVH and LV dilatation cause an in increase in end-diastolic pressure, followed by enlargement of the left atrium[9]. The association between LV geometric patterns, LA enlargement, and AF remains unknown. In this study, we investigated the association between LV geometric patterns, LA enlargement, and AF

Methods

Results

Conclusion