title: Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation.
abstract: OBJECTIVE
  There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling.
  
  
  METHODS
  The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LA(VOL)) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm.
  
  
  RESULTS
  IAS thickness was significantly correlated with maximal LAV (LAV(max)) (r = 0.288, p = 0.003), mean LA(VOL) (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEF(total); r = -0.213, p = 0.030), and active LAEF (LAEF(active); r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAV(max), minimal LAV, mean LA(VOL), LVEF(total), LVEF(active), and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LA(VOL) and LAEF(active) were independent risk factors for recurrence.
  
  
  CONCLUSIONS
  Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Im
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Han
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Utah Valley Regional Medical Center, Provo, UT, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Hwang
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D054087:Atrial Septum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Atrial remodeling; Atrial septum; Heart atria