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A new tissue doppler index in predicting future atrial fibrillation in patients with heart failure.
- Source :
-
Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2011 Dec; Vol. 97 (6), pp. 468-77. Date of Electronic Publication: 2011 Oct 14. - Publication Year :
- 2011
-
Abstract
- Background: Onset of atrial fibrillation (AF) in patients with heart failure (HF) is usually associated with a high occurrence of cardiovascular complications. E/(E'×S') ratio (E=early diastolic transmitral velocity, E'=early mitral annular diastolic velocity and S'=systolic mitral annulus velocity) has been shown to reflect left ventricular filling pressure.<br />Objective: We investigate whether E/(E'×S') could be a predictor of new-onset AF in patients with HF.<br />Methods: We analyzed 113 consecutive hospitalized patients with HF, in sinus rhythm, after appropriate medical treatment. Patients with histories of AF, inadequate echocardiographic images, congenital heart disease, paced rhythm, significant primary valvular disease, acute coronary syndrome, coronary revascularization during follow-up, severe pulmonary disease or renal failure were not included. E/(E'×S') was determined using the average of septal and lateral mitral annular velocities. The primary study end-point was the new-onset AF.<br />Results: During the follow-up period (35.7±11.2 months), 33 patients (29.2%) developed AF. Mean E/(E'×S') was 3.09±1.12 in these patients, while it was 1.72±1.34 in the other patients (p<0.001). The optimal E/(E'×S') cut-off to predict new-onset AF was 2.2 (88% sensitivity, 77% specificity). There were 64 patients (56.6%) with E/(E'×S')<2.2 and 49 (43.4%) with E/(E'×S')>2.2. New-onset AF was higher in patients with E/(E'×S')>2.2 than in patients with E/(E'×S')<2.2 [29 (59.1%) versus 4 (6.2%), p<0.001]. On multivariate Cox analysis including the variables that predicted AF on univariate analysis, E/(E'×S') was the only independent predictor of new-onset AF (hazard ratio=2.26, 95% confidence interval=1.25-4.09, p=0.007).<br />Conclusion: In patients with HF, E/(E'×S') seems to be a good predictor of new-onset AF.
- Subjects :
- Atrial Fibrillation physiopathology
Blood Flow Velocity physiology
Diastole
Echocardiography, Doppler
Epidemiologic Methods
Female
Heart Failure physiopathology
Humans
Male
Middle Aged
Mitral Valve physiopathology
Risk Factors
Stroke Volume physiology
Systole
Atrial Fibrillation diagnostic imaging
Heart Failure diagnostic imaging
Mitral Valve diagnostic imaging
Subjects
Details
- Language :
- English; Portuguese
- ISSN :
- 1678-4170
- Volume :
- 97
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Arquivos brasileiros de cardiologia
- Publication Type :
- Academic Journal
- Accession number :
- 22001955
- Full Text :
- https://doi.org/10.1590/s0066-782x2011005000099