Left atrial deformation analysis in patients with non-ischaemic dilated cardiomyopathy in atrial fibrillation
Ródenas-Alesina, Eduard (Universitat Autònoma de Barcelona. Departament de Medicina)
Lozano-Torres, Jordi (Universitat Autònoma de Barcelona. Departament de Medicina)
Tobías-Castillo, Pablo Eduardo (Universitat Autònoma de Barcelona. Departament de Medicina)
Badia-Molins, Clara (Universitat Autònoma de Barcelona. Departament de Medicina)
Vila-Olives, Rosa (Universitat Autònoma de Barcelona. Departament de Medicina)
Calvo-Barceló, Maria (Universitat Autònoma de Barcelona. Departament de Medicina)
Casas, Guillem (Universitat Autònoma de Barcelona. Departament de Medicina)
Soriano-Colomé, Toni (Universitat Autònoma de Barcelona. Departament de Medicina)
San Emeterio, Aleix Olivella (Universitat Autònoma de Barcelona. Departament de Medicina)
Fernández-Galera, Rubén (Universitat Autònoma de Barcelona. Departament de Medicina)
Méndez-Fernández, Ana B. (Universitat Autònoma de Barcelona. Departament de Medicina)
Barrabés, José A. (Universitat Autònoma de Barcelona. Departament de Medicina)
Ferreira-Gonzalez, Ignacio (Universitat Autònoma de Barcelona. Departament de Medicina)
Rodríguez Palomares, José Fernando (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2024
Abstract:	Atrial fibrillation (AF) is a common comorbidity in non-ischaemic dilated cardiomyopathy (NIDCM) affecting conventional measures of left atrial (LA) function. We aimed to determine whether LA function analysis could identify patients at higher risk of major cardiovascular events (MACEs). A retrospective study of patients with NIDCM in AF referred to a single centre for transthoracic echocardiography (TTE) between 2015 and 2019. Peak atrial longitudinal strain (PALS) was measured along with LA emptying fraction and LA filling index (LAFI = E wave/PALS). Cox regression analysis was conducted. A total of 153 patients were included [median age 74 years, left ventricular ejection fraction (LVEF) 35%], and 57 (37. 3%) had MACE after a median follow-up of 3. 2 years. LAFI was the only independent TTE parameter associated with MACE after adjustment for age, diabetes, LVEF, left ventricular global longitudinal strain (LV-GLS), and LA volume index [adjusted hazard ratio (HR) = 1. 02 per point increase, P = 0. 024], with the best cut-off at ≥15. LAFI ≥15 predicted each of MACE components when separately analysed: MACE HR = 1. 95, 95% confidence interval (CI) 1. 16-3. 30; cardiovascular death HR = 3. 68, 95% CI 1. 41-9. 56, heart failure admission HR = 2. 13, 95% CI 1. 19-3. 80, and ventricular arrhythmia HR = 4. 72, 95% CI 1. 52-14. 67. Higher LAFI was associated with worsening LV-GLS, E / e ', systolic pulmonary artery (PA) pressure, tricuspid annular plane systolic excursion, and right ventricular to PA coupling. LA deformation analysis is feasible in patients with NIDCM presenting with AF. LAFI may identify patients at higher risk of MACE and correlates with higher pulmonary pressures and worse right ventricular function, suggesting an elevation of left-sided ventricular pressures in patients with higher LAFI.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Left atrial strain ; Non-ischaemic dilated cardiomyopathy ; Atrial fibrillation ; Left atrial filling index ; Echocardiography
Published in:	European Heart Journal. Imaging Methods and Practice, Vol. 2 (june 2024) , ISSN 2755-9637

DOI: 10.1093/ehjimp/qyae063
PMID: 39224100

9 p, 3.7 MB

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