Echo-Doppler–derived indexes of ventricular stiffness and ventriculo-arterial interaction as predictors of new-onset atrial fibrillation in patients with heart failure. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Yoon, Ji; Kim, Myung-Hyun; Chung, Hyemoon; Choi, Eui-Young; Min, Pil-Ki; Yoon, Young; Lee, Byoung; Hong, Bum-Kee; Rim, Se-Joong; Kwon, Hyuck; Kim, Jong-Youn
• Is Part Of: Cardiovascular ultrasound. Volume 14:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2015-12
• Subjects: Left ventricular stiffness -- Atrial fibrillation -- Heart failure -- Diastolic dysfunction; Echocardiography -- Periodicals; Intravascular ultrasonography -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1207543
• DOI: 10.1186/s12947-016-0050-y
• Languages: English
• ISSNs: 1476-7120

Abstract

Abstract Background Atrial fibrillation (AF) is common in patients with heart failure (HF) and worsens their prognosis. Vulnerability to changes in loading is an important factor in the development of AF and is strongly influenced by ventricular stiffness and ventriculo-arterial interaction. The aim of this study was to investigate predictors of AF development in patients with HF. Methods We studied 349 patients with stable HF. The following parameters of ventricular stiffness and ventriculo-arterial interaction were derived from echo-Doppler measurements: left ventricular (LV) diastolic elastance (Ed), effective arterial elastance (Ea), LV end-systolic elastance (Ees) and ventricular–vascular coupling index (VVI). Results AF occurred in 57 (16.3 %) patients over a median follow up of 30.3 months. Echo-Doppler–derived parameters of ventricular stiffness and ventriculo-arterial interaction were closely associated with HF severity. Ed was independently associated with AF after adjustment for age, hypertension, diabetes mellitus, and left atrial volume index (hazard ratio [HR] 5.49, p = 0.018). Ea and VVI were also associated with new-onset AF (HR 1.66, p = 0.027, and HR 1.06, p = 0.001, respectively). Conclusions Echo-Doppler indexes of ventricular stiffness are closely associated with HF severity. LV diastolic elastance (Ed) is the strongest predictor of new-onset AF in HF patients.