Abstract
Backgrounds Paroxysmal atrial fibrillation (AF) frequently, but not always, progresses to persistent/permanent AF. The aim of this study was to evaluate the echocardiographic predictors of AF progression in patients with paroxysmal AF. Methods A multicenter, prospective, observational study was conducted that included 313 patients with paroxysmal AF who underwent two-dimensional speckle-tracking echocardiography. The diameter, volume, and mechanical function of the left atrium, including global strain (ε) and ε rate, were measured. Results Progression to persistent or permanent AF occurred in 52 patients (16.6%) during a median follow-up period of 26 months. Echocardiographic measure of left atrial (LA) diameter, volume, and function (E velocity, E/A and E/e′ ratio, LA expansion index, active emptying fraction, global longitudinal ε and ε rate) were associated with AF progression. LA ε ≤ 30.9% was the strongest predictor of AF progression, which was associated with a more than fourfold hazard increase for AF progression (hazard ratio, 4.224; P =.001). LA diameter > 39 mm and maximal LA volume index > 34.2 mL/m were associated with about a twofold hazard increase for AF progression (hazard ratios, 1.994 and 2.649; P =.016 and P =.001, respectively). When adjusted for a model combining maximal LA volume index, E velocity, LA expansion index, and active emptying fraction, LA ε ≤ 30.9% maintained a more than threefold hazard increase for AF progression (adjusted hazard ratio, 3.970; P =.003). Conclusions Echocardiographic measures of LA diameter, volume, and mechanical function, including LA ε, were associated with AF progression. LA ε was the strongest independent predictor of AF progression and is expected to serve as a valuable predictor of AF progression.
Original language | English |
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Pages (from-to) | 709-717 |
Number of pages | 9 |
Journal | Journal of the American Society of Echocardiography |
Volume | 28 |
Issue number | 6 |
DOIs | |
Publication status | Published - 2015 Jun 1 |
Bibliographical note
Publisher Copyright:© 2015 American Society of Echocardiography.
Keywords
- Atrial fibrillation
- Left atrium
- Strain
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine