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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Autores principales:	Erez Marcusohn, Ofer Kobo, Maria Postnikov, Danny Epstein, Yoram Agmon, Lior Gepstein, Yaron Hellman, Robert Zukermann
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/90ec4ccebc8847f1bd3715fd4a528a69
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spelling	oai:doaj.org-article:90ec4ccebc8847f1bd3715fd4a528a692021-12-04T16:05:20ZLeft Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors10.15420/cfr.2021.172057-75592057-7540https://doaj.org/article/90ec4ccebc8847f1bd3715fd4a528a692021-11-01T00:00:00Zhttps://www.cfrjournal.com/articleindex/cfr.2021.17https://doaj.org/toc/2057-7540https://doaj.org/toc/2057-7559Background: 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.Erez MarcusohnOfer KoboMaria PostnikovDanny EpsteinYoram AgmonLior GepsteinYaron HellmanRobert ZukermannRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiac Failure Review , Vol 7, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 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
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
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
title	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_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_sort	left ventricular systolic dysfunction due to atrial fibrillation: clinical and echocardiographic predictors
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/90ec4ccebc8847f1bd3715fd4a528a69
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Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors

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