TY - JOUR
T1 - Rest and Stress Left Atrial Dysfunction in Patients with Atrial Fibrillation
AU - on behalf of the Stress Echo 2030 Study Group
AU - Zagatina, Angela
AU - Rivadeneira Ruiz, Maria
AU - Ciampi, Quirino
AU - Wierzbowska-Drabik, Karina
AU - Kasprzak, Jaroslaw
AU - Kalinina, Elena
AU - Begidova, Irina
AU - Peteiro, Jesus
AU - Arbucci, Rosina
AU - Marconi, Sofia
AU - Lowenstein, Jorge
AU - Boshchenko, Alla
AU - Manganelli, Fiore
AU - Čelutkienė, Jelena
AU - Morrone, Doralisa
AU - Merli, Elisa
AU - Re, Federica
AU - Borguezan-Daros, Clarissa
AU - Haberka, Maciej
AU - Saad, Ariel K.
AU - Djordjevic-Dikic, Ana
AU - Ratanasit, Nithima Chaowalit
AU - Rigo, Fausto
AU - Colonna, Paolo
AU - Pretto, José Luis de Castro e.Silva
AU - Mori, Fabio
AU - D’Alfonso, Maria Grazia
AU - Ostojic, Miodrag
AU - Stanetic, Bojan
AU - Preradovic, Tamara Kovacevic
AU - Costantino, Fabio
AU - Barbieri, Andrea
AU - Citro, Rodolfo
AU - Pitino, Annalisa
AU - Pepi, Mauro
AU - Carerj, Scipione
AU - Pellikka, Patricia A.
AU - Picano, Eugenio
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/9
Y1 - 2023/9
N2 - Background: Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. Aim: This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. Methods: In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 ± 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. Results: LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 ± 12.2, Group 2 = 31.6 ± 12.9, Group 3 = 43.3 ± 19.7 mL/m2, p < 0.001) and at peak stress (Group 1 = 26.2 ± 12.0, Group 2 = 31.2 ± 12.2, Group 3 = 43.9 ± 19.4 mL/m2, p < 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 ± 8.5%, Group 2 = 23.2 ± 11.2%, Group 3 = 8.5 ± 6.5%, p < 0.001) and at peak stress (Group 1 = 26.9 ± 10.1, Group 2 = 23.8 ± 11.0 Group 3 = 10.7 ± 8.1%, p < 0.001). Stress B-lines (≥2) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p < 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). Conclusions: In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.
AB - Background: Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. Aim: This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. Methods: In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 ± 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. Results: LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 ± 12.2, Group 2 = 31.6 ± 12.9, Group 3 = 43.3 ± 19.7 mL/m2, p < 0.001) and at peak stress (Group 1 = 26.2 ± 12.0, Group 2 = 31.2 ± 12.2, Group 3 = 43.9 ± 19.4 mL/m2, p < 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 ± 8.5%, Group 2 = 23.2 ± 11.2%, Group 3 = 8.5 ± 6.5%, p < 0.001) and at peak stress (Group 1 = 26.9 ± 10.1, Group 2 = 23.8 ± 11.0 Group 3 = 10.7 ± 8.1%, p < 0.001). Stress B-lines (≥2) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p < 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). Conclusions: In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.
KW - atrial fibrillation
KW - left atrium
KW - reservoir function
KW - strain
KW - stress echocardiography
UR - http://www.scopus.com/inward/record.url?scp=85172875514&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85172875514&partnerID=8YFLogxK
U2 - 10.3390/jcm12185893
DO - 10.3390/jcm12185893
M3 - Article
AN - SCOPUS:85172875514
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 18
M1 - 5893
ER -