title: Echocardiographic Parameters Associated With Asymmetrical Structural Remodeling In Patients With Or Without Atrial Fibrillation.
abstract: OBJECTIVE
  Left atrial (LA) dilation can evolve into asymmetrical remodeling. The aim of this study was to determine the echocardiographic parameters associated with LA asymmetric structural remodeling (ASR) in patients with and without nonvalvular atrial fibrillation (AF).
  
  
  RESULTS
  A total of 170 patients with a dilated LA were prospectively enrolled. ASR was defined as an atrium shape that is no longer ellipsoidal (LA basal dimension measured at the junction between the pulmonary vein and atrium greater than the mitral annular dimension). Symmetric structural remodeling (SSR) was defined as all other cases. Echocardiographic parameters of LA function and left ventricular diastolic function, measured by pulsed-wave Doppler and Tissue Doppler Imaging, were analyzed to identify the parameters associated with ASR. The mean age of the patients was 67 ± 11 years. Forty-one percent had a stable sinus rhythm (SR), and 59% had AF. LA-ASR was detected in 66% of the patients: 55% with AF and 45% with SR (p=0.002). The mean LA-ASR and LA-SSR volume indexes were 49 ± 14 ml/m² and 29 ± 13 ml/m², respectively (p<0.001). LA systolic myocardial velocity (p=0.036) and peak systolic pulmonary venous flow velocity (p=0.033) were the parameters best associated with ASR. The sensitivity and specificity of both parameters, based on ROC curve analysis, were 77 and 70%, respectively. The AUC was 0.765 (95% CI: 0.662-0.849, p=0.0001).
  
  
  CONCLUSIONS
  LA dilation is associated with a great number of asymmetrical structural remodeling. Echocardiographic parameters that reflect LA reservoir function are best associated with asymmetrical remodeling.
authors.affiliation: III Medical Clinic of University Hospital "Sf. Spiridon"; University of Medicine and Pharmacy "Gr. T. Popa"; University of Medicine and Pharmacy "Gr. T. Popa".
authors.forename: Mariana
authors.initials: M
authors.lastname: Floria
authors.affiliation: CHU Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.affiliation: "Prof. Dr. G. I.M. Georgescu" Cardiovascular Disease Institute Iasi, Romania.
authors.forename: Erwin
authors.initials: E
authors.lastname: Schroeder
authors.affiliation: University of Medicine and Pharmacy "Gr. T. Popa"; University of Medicine and Pharmacy "Gr. T. Popa".
authors.forename: Catalina Arsenescu
authors.initials: CA
authors.lastname: Georgesu
keywords: Atrial Fibrillation; Left Atrium; Reservoir Function; Structural Remodeling