Preoperative Left Atrial Mechanical Dysfunction Predicts Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Operation - A Velocity Vector Imaging-Based Study -
- 1 January 2010
- journal article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 74 (10), 2109-2117
- https://doi.org/10.1253/circj.cj-10-0197
Abstract
The aim of the present study was to evaluate pre-existent subclinical mechanical atrial dysfunction in patients with postoperative atrial fibrillation (POAF) by using novel echocardiographic techniques. Ninety-six patients with sinus rhythm, undergoing coronary artery bypass graft (CABG) operation were prospectively enrolled. Preoperative left atrial (LA) reservoir, conduit and booster functions were evaluated by 3 different methods: conventional echocardiography, tissue Doppler imaging (TDI), and 2-dimensional strain imaging based-velocity vector imaging (VVI). POAF occurred in 25 out of 96 patients (26%). LA volume index (LAVI) was the only conventional parameter associated with POAF. TDI-derived LA velocities were similar in study groups. In VVI analysis, LA systolic strain, strain rate (SRs) and early diastolic strain rate (ESRd) were impaired in patients who developed POAF after CABG (P=0.0001). Age, LAVI, LA peak systolic strain, SRs and ESRd were found to be the independent predictors of POAF. The optimal cut-off point of 44.0% (88.7% sensitivity, 96% specificity) for LA strain, 1.7 s(-1) (88% sensitivity, 86.2% specificity) for SRs and 1.95 s(-1) (sensitivity 72%, 70.4% specificity) for ESRd predicted POAF in this study. VVI-derived strain imaging could be used as an adjunctive non-invasive method for evaluating subclinical atrial mechanical dysfunction in patients undergoing CABG. This might help us to identify patients with high risk of POAF in clinical practice.Keywords
This publication has 24 references indexed in Scilit:
- Subclinical Left Ventricular Dysfunction in Asymptomatic Severe Aortic Regurgitation Patients with Normal Ejection Fraction: A Combined Tissue Doppler and Velocity Vector Imaging StudyEchocardiography, 2010
- Inflammation and Atrial FibrillationCirculation Journal, 2010
- Postoperative Atrial FibrillationCardiology Clinics, 2009
- Echocardiographic evaluation of left atrial size and function: Current understanding, pathophysiologic correlates, and prognostic implicationsAmerican Heart Journal, 2008
- Tracing the origins of postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenonEuropean Journal of Preventive Cardiology, 2008
- Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetesEuropean Journal of Heart Failure, 2008
- Clinical Utility of Tissue Doppler Imaging in Prediction of Atrial Fibrillation After Coronary Artery Bypass GraftingThe Annals of Thoracic Surgery, 2007
- Strain Rate Imaging for Noninvasive Functional Quantification of the Left Atrium: Comparative Studies in Controls and Patients With Atrial FibrillationJournal of the American Society of Echocardiography, 2005
- Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular ContractilityCirculation, 2002
- Best method in clinical practice and in research studies to determine left atrial sizeThe American Journal of Cardiology, 1999