Novel algorithm for non-invasive estimation of left atrial pressure in patients with atrial fibrillation.

IF 6.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jiwon Seo, Hee Tae Yu, In-Soo Kim, Tae-Hoon Kim, Boyoung Joung, Hui-Nam Pak, Iksung Cho, Chi Young Shim, Geu-Ru Hong, Jong-Won Ha
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引用次数: 0

Abstract

Aims: Determining elevated left atrial (LA) pressure is crucial in patients with atrial fibrillation (AF), yet non-invasive estimation using echocardiography remains unclear. This study aimed to identify useful echocardiographic indices for identifying elevated LA pressure in patients with AF.

Methods and results: Patients with paroxysmal or persistent AF referred for catheter ablation at two tertiary hospitals were prospectively enrolled. Mean LA pressure was measured immediately after transseptal puncture. Elevated mean LA pressure was defined as ≥15 mmHg. Transthoracic echocardiography was performed to acquire the guideline-recommended parameters. A total of 176 patients were included, and 63 (36%) patients had a mean LA pressure ≥15 mmHg. Patients with elevated LA pressure had more frequent hypertension, larger LA, higher septal E/e', and worse LA strain than the remaining patients. The correlations between mean LA pressure and each echocardiographic parameter were weak. Septal E/e' ratio showed the best correlation with mean LA pressure (r = 0.351, P < 0.001), and septal E/e' ratio ≥11 was the best parameter (area under the curve = 0.7, sensitivity = 65%, specificity = 73%, accuracy = 70%) to identify elevated mean LA pressure. A hierarchical algorithm consisting of septal E/e' ratio, LA reservoir strain, and LA volume index improved identification of patients with elevated mean LA pressure (sensitivity = 61%, specificity = 91%, accuracy = 80%).

Conclusion: In patients with AF, the septal E/e' ratio was the best single parameter for identifying elevated mean LA pressure. A hierarchical algorithm combining the septal E/e' ratio, LA reservoir strain, and LA volume index helps identify elevated LA pressure in patients with AF.

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来源期刊
European Heart Journal - Cardiovascular Imaging
European Heart Journal - Cardiovascular Imaging CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
9.70%
发文量
708
审稿时长
4-8 weeks
期刊介绍: European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology. The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.
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