TY - JOUR
T1 - Echocardiographic predictors of progression to persistent or permanent atrial fibrillation in patients with paroxysmal atrial fibrillation (E6P Study)
AU - Yoon, Yeonyee E.
AU - Oh, Il Young
AU - Kim, Sung Ai
AU - Park, Kyoung Ha
AU - Kim, Seong Hwan
AU - Park, Jae Hyeong
AU - Kim, Jeong Eun
AU - Lee, Seung Pyo
AU - Kim, Hyung Kwan
AU - Kim, Yong Jin
AU - Sohn, Dae Won
AU - Cho, Goo Yeong
N1 - Publisher Copyright:
© 2015 American Society of Echocardiography.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Left atrium
KW - Strain
UR - http://www.scopus.com/inward/record.url?scp=84930083187&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2015.01.017
DO - 10.1016/j.echo.2015.01.017
M3 - Article
C2 - 25704553
AN - SCOPUS:84930083187
SN - 0894-7317
VL - 28
SP - 709
EP - 717
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 6
ER -