title: Usefulness of left ventricular diastolic dysfunction assessed by pulsed tissue Doppler imaging as a predictor of atrial fibrillation recurrence after successful electrical cardioversion.
abstract: The impact of left ventricular (LV) diastolic dysfunction on risk of atrial fibrillation (AF) recurrence is still unknown. The aim of this study was to assess the role of LV diastolic dysfunction in predicting AF recurrence after successful electrical cardioversion in patients with nonvalvular AF. In 51 patients with a first episode of nonvalvular AF undergoing successful electrical cardioversion, tissue Doppler echocardiography was performed to measure peak early diastolic mitral annulus velocity (E(m)) and the ratio of mitral inflow to mitral annulus velocity at end-diastole (E/E(m)). Clinical end points were recurrent persistent AF at 2-week follow-up (early AF recurrence [ERAF]) and at 1-year follow-up (including ERAF and late AF recurrence). Seventeen patients showed evidence of ERAF, whereas late AF recurrence occurred in another 5 patients. In time-independent analysis E/E(m) (odds ratio [OR] 1.746, p = 0.0084) and indexed LV end-systolic volume (OR 1.083, p = 0.040) were independent predictors of ERAF. Based on a logistic model risk of ERAF was 25% for an E/E(m) of 5.6 but increased to 50% for an E/E(m) of 8.1 and to 75% for an E/E(m) of 10.5. In time-dependent analysis E/E(m) emerged as the only predictor of ERAF (OR 1.757, p = 0.0078). E/E(m) also independently predicted risk of recurrence at 1 year in time-independent (OR 1.757, p = 0.0078) and time-dependent (OR 1.319, p = 0.0003) analyses. In conclusion LV diastolic dysfunction independently predicts AF recurrence in patients with nonvalvular AF undergoing successful electrical cardioversion.
authors: Department of Cardiovascular Diseases, University of Siena, Italy. marialuce@skarabeo.net
authors: Maria
authors: M
authors: Caputo
authors: Rossella
authors: R
authors: Urselli
authors: Eugenia
authors: E
authors: Capati
authors: Romina
authors: R
authors: Navarri
authors: Liliana
authors: L
authors: Sinesi
authors: Fabio
authors: F
authors: Furiozzi
authors: Piercarlo
authors: P
authors: Ballo
authors: Alberto
authors: A
authors: Palazzuoli
authors: Roberto
authors: R
authors: Favilli
authors: Sergio
authors: S
authors: Mondillo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003971:Diastole; D015150:Echocardiography, Doppler; D004554:Electric Countershock; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*