کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5976293 | 1576209 | 2013 | 6 صفحه PDF | دانلود رایگان |
BackgroundLeft atrial (LA) size and function change with chronically increased left ventricular (LV) filling pressures. It remains unclear whether these variations in LA parameters can predict new-onset atrial fibrillation (AF) in asymptomatic patients with aortic stenosis (AS).MethodsData were obtained in asymptomatic patients with mild-to-moderate AS (2.5 ⤠transaortic Doppler velocity â¤Â 4.0 m/s), preserved LV ejection fraction (EF), no previous AF, and were enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis study. Peak-aortic velocity, LAmax volume & LAmin volume were measured by echocardiography. LA conduit (LAcon) volume was defined as LV stroke volume â LA stroke volume. LA function was expressed as LA-EF (LAmax â LAmin volume/LAmax).ResultsIn the 1159 patients included, new-onset AF occurred in 71 patients (6.1%) within a mean follow-up of 4.2 ± 0.9 years. Mean age was 66 ± 9.7 years, aortic valve area index 0.6 ± 0.2 cm2/m2, LV mass 99.2 ± 29.7 g/m2, LAmax volume 34.6 ± 12.0 mL/m2, LAmin volume 17.9 ± 9.3 mL/m2, LA-EF 50 ± 15% and LAcon volume 45 ± 21 mL/m2. Baseline LAmin volume predicted new-onset AF in Cox multivariable analysis (HR:2.3 [95%CI:1.3-4.4], P < 0.01), and added prognostic information on AF development beyond conventional risk factors (likelihood ratio, P < 0.01). In comparison of c-indexes LAmin volume was superior to all other LA measurements. Net reclassification index improved by 15.9% when adding LAmin volume to a model with classic risk factors for AF (P = 0.01).ConclusionLAmin volume independently predicted new-onset AF in patients with asymptomatic AS and was superior to LA-EF, LAcon and LAmax volumes and conventional risk factors.
Journal: International Journal of Cardiology - Volume 168, Issue 3, 3 October 2013, Pages 2322-2327