Left ventricular diastolic dysfunction in atrial fibrillation: predictors and relation with symptom severity.
BACKGROUND
Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD and AF-related symptom severity has not been well studied.


METHODS
In 124 consecutive patients (mean age 61 ± 11years, 60% male) with paroxysmal (n = 70) or persistent AF (n = 54) referred for AF catheter ablation, LVDD was evaluated according to current guidelines using transthoracic echocardiography. AF-related symptom severity was quantified using the European Heart Rhythm Association score.


RESULTS
LVDD was present in 46 patients (37%). In uni- and multivariable regression analysis, age (OR 1.068 per year, 95% CI 1.023-1.115, P = 0.003) and persistent AF (OR 2.427 vs. paroxysmal AF, 95% CI 1.112-5.3, P = 0.026) were associated with LVDD. LVDD was found in 11% with mild AF symptoms (n = 27) as opposed to 44% in patients with moderate-severe AF symptoms (n = 97, P = 0.002). Thus, the OR for moderate-severe AF symptoms was 6.368 (1.797-22.568, P = 0.004) in the presence of LVDD.


CONCLUSIONS
LVDD (1) occurs frequently in AF, (2) is associated with advancing age and AF progression and (3) is correlated with symptom severity in AF.
From the Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany. jedrzejkosiuk@hotmail.com
Jedrzej
J
Kosiuk
Yves
Y
Van Belle
Kerstin
K
Bode
Jelena
J
Kornej
Arash
A
Arya
Sascha
S
Rolf
Daniela
D
Husser
Gerhard
G
Hindricks
Andreas
A
Bollmann
D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D018450:Disease Progression; D015150:Echocardiography, Doppler; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016277:Ventricular Function, Left