Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors
Background: Diagnosis of AF-induced cardiomyopathy can be challenging and relies on ruling out other causes of cardiomyopathy and, after restoration of sinus rhythm, recovery of left ventricular (LV) function. The aim of this study was to identify clinical and echocardiographic predictors for develo...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2021-11-01
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| Series: | Cardiac Failure Review |
| Online Access: | https://www.cfrjournal.com/articleindex/cfr.2021.17 |
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| author | Erez Marcusohn Ofer Kobo Maria Postnikov Danny Epstein Yoram Agmon Lior Gepstein Yaron Hellman Robert Zukermann |
| author_facet | Erez Marcusohn Ofer Kobo Maria Postnikov Danny Epstein Yoram Agmon Lior Gepstein Yaron Hellman Robert Zukermann |
| author_sort | Erez Marcusohn |
| collection | DOAJ |
| description | Background: Diagnosis of AF-induced cardiomyopathy can be challenging and relies on ruling out other causes of cardiomyopathy and, after restoration of sinus rhythm, recovery of left ventricular (LV) function. The aim of this study was to identify clinical and echocardiographic predictors for developing cardiomyopathy with systolic dysfunction in patients with atrial tachyarrhythmia. Methods: This retrospective study was conducted in a large tertiary care centre and compared patients who experienced deterioration of LV ejection fraction (EF) during paroxysmal AF, demonstrated by precardioversion transoesophageal echocardiography with patients with preserved LV function during AF. All patients had documented preserved LVEF at baseline (EF >50%) while in sinus rhythm. Results: Of 482 patients included in the final analysis, 80 (17%) had reduced and 402 (83%) had preserved LV function during the precardioversion transoesophageal echocardiography. Patients with reduced LVEF were more likely to be men and to have a more rapid ventricular response during AF or atrial flutter (AFL). A history of prosthetic valves was also identified as a risk factor for reduced LVEF. Patients with reduced LVEF also had higher incidence of tricuspid regurgitation and right ventricular dysfunction. Conclusion: In ‘real-world’ experience, male patients with rapid ventricular response during paroxysmal AF or AFL are more prone to LVEF reduction. Patients with prosthetic valves are also at risk for LVEF reduction during AF/AFL. Finally, tricuspid regurgitation and right ventricular dysfunction may indicate relatively long-standing AF with an associated reduction in LVEF. |
| format | Article |
| id | doaj-art-90ec4ccebc8847f1bd3715fd4a528a69 |
| institution | OA Journals |
| issn | 2057-7540 2057-7559 |
| language | English |
| publishDate | 2021-11-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Cardiac Failure Review |
| spelling | doaj-art-90ec4ccebc8847f1bd3715fd4a528a692025-08-20T02:37:42ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592021-11-01710.15420/cfr.2021.17Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic PredictorsErez Marcusohn0Ofer Kobo1Maria Postnikov2Danny Epstein3Yoram Agmon4Lior Gepstein5Yaron Hellman6Robert Zukermann7Department of Cardiology, Rambam Health Care Campus, Haifa, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera, IsraelDepartment of Cardiology, Rambam Health Care Campus, Haifa, IsraelIntensive Care Unit, Rambam Health Care Campus, Haifa, IsraelDepartment of Cardiology, Rambam Health Care Campus, Haifa, Israel; Rappaport – Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, IsraelDepartment of Cardiology, Rambam Health Care Campus, Haifa, Israel; Rappaport – Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, IsraelDepartment of Cardiology, Rambam Health Care Campus, Haifa, IsraelDepartment of Cardiology, Rambam Health Care Campus, Haifa, IsraelBackground: Diagnosis of AF-induced cardiomyopathy can be challenging and relies on ruling out other causes of cardiomyopathy and, after restoration of sinus rhythm, recovery of left ventricular (LV) function. The aim of this study was to identify clinical and echocardiographic predictors for developing cardiomyopathy with systolic dysfunction in patients with atrial tachyarrhythmia. Methods: This retrospective study was conducted in a large tertiary care centre and compared patients who experienced deterioration of LV ejection fraction (EF) during paroxysmal AF, demonstrated by precardioversion transoesophageal echocardiography with patients with preserved LV function during AF. All patients had documented preserved LVEF at baseline (EF >50%) while in sinus rhythm. Results: Of 482 patients included in the final analysis, 80 (17%) had reduced and 402 (83%) had preserved LV function during the precardioversion transoesophageal echocardiography. Patients with reduced LVEF were more likely to be men and to have a more rapid ventricular response during AF or atrial flutter (AFL). A history of prosthetic valves was also identified as a risk factor for reduced LVEF. Patients with reduced LVEF also had higher incidence of tricuspid regurgitation and right ventricular dysfunction. Conclusion: In ‘real-world’ experience, male patients with rapid ventricular response during paroxysmal AF or AFL are more prone to LVEF reduction. Patients with prosthetic valves are also at risk for LVEF reduction during AF/AFL. Finally, tricuspid regurgitation and right ventricular dysfunction may indicate relatively long-standing AF with an associated reduction in LVEF.https://www.cfrjournal.com/articleindex/cfr.2021.17 |
| spellingShingle | Erez Marcusohn Ofer Kobo Maria Postnikov Danny Epstein Yoram Agmon Lior Gepstein Yaron Hellman Robert Zukermann Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors Cardiac Failure Review |
| title | Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors |
| title_full | Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors |
| title_fullStr | Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors |
| title_full_unstemmed | Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors |
| title_short | Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors |
| title_sort | left ventricular systolic dysfunction due to atrial fibrillation clinical and echocardiographic predictors |
| url | https://www.cfrjournal.com/articleindex/cfr.2021.17 |
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