|
|
The value of right ventricular function in predicting recurrence after ablation of atrial fibrillation |
LIU Ying-xian, CHEN Wei, WANG Jia-li, GAO Peng, CHENG Zhong-wei, FANG Quan, FANG Li-gang |
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of
Medical Science and Peking Union Medical College, Beijing 100730, China |
|
|
Abstract Objective: To investigate prognostic values of right ventricular functional parameters in predicting atrial fibrillation(AF) recurrence after ablation. Methods: Perspective cohort study, 55 patients with AF in cardiology department of PUMCH from Jan 2013 to Jan 2015 were involved. Echocardiography was practiced before the radiofrequency ablation surgery. 2D gray scale echocardiography images from 4-chamber view were reserved. Echo-Pac software system was used to generate right and left ventricular time-strain curves. Follow-up was performed every 6 months, and the endpoint events were recorded. Results: AF patients with early recurrence after the ablation manifested as significant decreased tricuspid annular plane systolic excursion(TAPSE) and right ventricular global peak longitudinal strain(RV-PLSS-T). The percentage of early recurrence was obviously elevated in AF patients with RV longitudinal dysfunction(defined as S’<10 cm/s, or RV-PLSS-T<17%)(P<0.05, respectively). Early recurrence of AF were significantly positively correlated with durations of AF, TAPSE and RV-PLSS-T(OR=1.039, 0.852, 0.813, P<0.05, respectively). However, after adjusting in binary logistic model, only course of AF(OR=1.050) and RV-PLSS-T(OR=0.770) were independent risk factors of early recurrence of AF after ablation(P<0.05 respectively). AF patients with decreased RV longitudinal strains showed elevating percentages of endpoint events and shortening event-free survival. Conclusions: AF patients with worse RV longitudinal systolic function were more prone to suffer from early recurrence after ablation. Decreasing RV strains might help to predict endpoint events including AF recurrence, cardiovascular readmission and arrhythmic symptoms.
|
Received: 30 November 2018
|
|
|
|
|
[1]Melenovsky V, Hwang SJ, Lin G, et al. Right heart dysfunction in heart failure with preserved ejection fraction[J]. Eur Heart J, 2014, 35(48): 3452-3462.
[2]Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography[J]. J Am Soc Echocardiogr, 2010, 23(7): 685-713.
[3]Chou SH, Kuo CT, Hsu LA, et al. Single-beat determination of right ventricular function in patients with atrial fibrillation[J]. Echocardiography, 2010, 27(10): 1188-1193.
[4]Aziz EF, Kukin M, Javed F, et al. Right ventricular dysfunction is a strong predictor of developing atrial fibrillation in acutely decompensated heart failure patients, ACAP-HF data analysis[J]. J Card Fail, 2010, 16(10): 827-834.
[5]Haddad F, Hunt SA, Rosenhal DN, et al. Right ventricular function in cardiovascular disease, part Ⅰ: Anatomy, physiology, aging, and functional assessment of the right ventricle[J]. Circulation, 2008, 117(11): 1436-1448.
[6]Dell’Italia LJ. Mechanism of postextrasystolic potentiation in the right ventricle[J]. Am J Cardiol, 1990, 65(11): 736-741.
[7]Houltz B, Johansson B, Berglin E, et al. Left ventricular diastolic function and right atrial size are important rhythm outcome predictors after intraoperative ablation for atrial fibrillation[J]. Echocardiography, 2010, 27(8): 961-968.
[8]Girard SE, Nishimura RA, Warnes CA, et al. Idiopathic annular dilation: a rare cause of isolated severe tricuspid regurgitation[J]. J Heart Valve Dis, 2000, 9(2): 283-287.
[9]Marui A, Mochizuki T, Mitsui N, et al. Isolated tricuspid regurgitation caused by a dilated tricuspid annulus[J]. (下转806页)
(上接788页)Ann Thorac Surg, 1998, 66(2): 560-562.
[10]Nwiloh JO. Isolated severe tricuspid regurgitation in a post pneumonectomy patient with chronic atrial fibrillation[J]. Ann Thorac Cardiovasc Surg, 2012, 18(2): 132-135.
[11]Haddad F, Doyle R, Murphy DJ, et al. Right ventricular function in cardiovascular disease, part Ⅱ: Pathophysiology, clinical importance, and management of right ventricular failure[J]. Circulation, 2008, 117(13): 1717-1731.
[12]Voelkel NF, Quaife RA, Leinwand LA, et al. Right Ventricular Function and Failure: Report of a National Heart, Lung, and Blood Institute Working Group on Cellular and Molecular Mechanisms of Right Heart Failure[J]. Circulation, 2006, 114(17): 1883-1891.
[13]Akoum N, Hamdan MH. Atrial fibrillation and congestive heart failure: A two-way street[J]. Curr Heart Fail Rep, 2007, 4(2): 78-83.
[14]Ollivier R, Donal E, Veillard D, et al. Early and late cardiac ventricular reverse remodeling after catheter ablation for lone paroxysmal atrial fibrillation[J]. Ann Cardiol Angeiol(Paris), 2011, 60(1): 1-8.
[15]Alam M, Samad BA, Hedman A, et al. Cardioversion of atrial fibrillation and its effect on right ventricular function as assessed by tricuspid annular motion[J]. Am J Cardiol, 1999, 84(10): 1256-1258.
[16]Fukuda Y, Tanaka H, Sugiyama D, et al. Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension[J]. J Am Soc Echocardiogr, 2011, 24(10): 1101-1108.
[17]Maffessanti F, Gripari P, Tamborini G, et al. Evaluation of right ventricular systolic function after mitral valve repair: a two-dimensional Doppler, speckle-tracking, and three-dimensional echocardiographic study[J]. J Am Soc Echocardiogr, 2012, 25(7): 701-708.
[18]Verhaert D, Mullens W, Borowski A, et al. Right ventricular sesponse to intensive medical therapy in advanced decompensated heart failure[J]. Circ Heart Fail, 2010, 3(3): 340-346.
[19]de Groote P, Millaire A, Foucher-Hossein C, et al. Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure[J]. J Am Coll Cardiol, 1998, 32(4): 948-954.
[20]Ghio S, Recusani F, Klersy C, et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy[J]. Am J Cardiol, 2000, 85(7): 837-842.
[21]Di Salvo TG, Mathier M, Semigran MJ, et al. Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure[J]. J Am Coll Cardiol, 1995, 25(5): 1143-1153.
[22]Cameli M, Righini FM, Lisi M, et al. Comparison of right versus left ventricular strain analysis as a predictor of outcome in patients with systolic heart failure referred for heart transplantation[J]. Am J Cardiol, 2013, 112(11): 1778-1784.
[23]Guendouz S, Rappeneau S, Nahum J, et al. Prognostic significance and normal values of 2D strain to assess right ventricular systolic function in chronic heart failure[J]. Circ J, 2012, 76(1): 127-136.
[24]Antoni ML, Scherptong RW, Atary JZ, et al. Prognostic value of right ventricular function in patients after acute myocardial infarction treated with primary percutaneous coronary intervention[J]. Circ Cardiovasc Imaging, 2010, 3(3): 264-271.
[25]Teske AJ, Cox MG, De Boeck BW, et al. Echocardiographic tissue deformation imaging quantifies abnormal regional right ventricular function in arrhythmogenic right ventricular dysplasia/cardiomyopathy[J]. J Am Soc Echocardiogr, 2009, 22(8): 920-927. |
|
|
|