Prognostic Implication of the Left Atrial Appendage Mechanical Reserve After Cardioversion of Atrial Fibrillation
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概要
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Background This study aimed to demonstrate the long-term prognostic implication of left atrial appendage (LAA) mechanical reserve determined after electrical cardioversion (CV) of atrial fibrillation (AF). Methods and Results 53 successfully cardioverted chronic AF patients were studied (M/F=40/13, mean age =59±3). LAA emptying velocity (LAAEV) and filling velocity (LAAFV) were measured using transesophageal echocardiography (TEE) before cardioversion, immediately after CV, and with isoproterenol infusion. TEE was done at baseline, 1 month, 3-6 months, and 1 year after CV. At 1-year follow-up, 27 patients remained in sinus rhythm (SR, Group 1) and 26 patients showed AF recurrence (Group 2). Baseline clinical and echocardiographic findings were similar between the 2 groups. Immediately after CV, LAAEV and LAAFV decreased similarly in both groups. With isoproterenol infusion, the increase of LAAEV was greater in group 1 than in group 2. Multivariate analysis revealed that the peak increase of LAAEV after isoproterenol infusion was an independent predictor for SR maintenance (odds ratio 1.044, 95% confidence interval 1.014 to 1.075; p=0.0033). Prediction model consisting of the peak increase of LAAEV (>34.4cm/s) and E/A ratio immediately after CV (<2.5) showed a good predictability for SR maintenance (correct ratio 69.8%). Conclusion This study presents a valid evaluation method for LAA mechanical reserve and demonstrated that LAA mechanical reserve is responsible for the maintenance of SR.
- 社団法人日本循環器学会の論文
- 2008-01-20
著者
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KIM Young-Hoon
Korea University College of Medicine
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Kim Young
Department Of Electronics Engineering Korea Advance Intitute Of Science & Technology
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Lim Do
Department Of Cardiology Cardiovascular Center Korea University Hospital
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Lim Do-sun
Cardiovascular Center Korea University Anam Hospital
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Lim Hong
Cardiovascular Center Korea University Guro Hospital
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Shim Wan
Korea University Medical Center
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Ro Young
Korea University Medical Center
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Lim Hong
Division Of Cardiology Cardiovascular Center
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Kim Yong
Korea University College Of Medicine
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Lim Do
Department Of Cardiology Cardiovascular Center Korea University Anam Hospital
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Shin Sung
Korea University Hospital
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Shin Sung
Department Of Cardiology Cardiovascular Center Korea University Hospital
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Park Mi
Department Of Physiological Anthropology Kyushu University
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Pak Hui-num
Korea University Medical Center
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Kim Young
Department Of Agricultural Chemistry The University Of Tokyo
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Kim Young
Korea University Cardiovascular Center
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Kim Young-hoon
Korea University Cardiovascular Center
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Shim Wan
Department Of Cardiology Cardiovascular Center Korea University Anam Hospital
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Park Mi
Department Of Cardiology Sejong General Hospital
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Oh Woong
Department of Cardiology, Cardiovascular Center, Korea University Hospital
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Lim Hong
Department of Cardiology, Cardiovascular Center, Korea University Hospital
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Pak Hui
Department of Cardiology, Cardiovascular Center, Korea University Hospital
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Ro Young
Department of Cardiology, Sejong General Hospital
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Kim Young-hoon
Department Of Cardiology Cardiovascular Center Korea University Anam Hospital
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Lim Do-sun
Department Of Cardiology Cardiovascular Center Korea University Anam Hospital
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Ro Young
Department Of Cardiology Cardiovascular Center Korea University Hospital
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Kim Yong
Department Of Cardiology Cardiovascular Center Korea University Anam Hospital
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Pak Hui
Korea University Cardiovascular Center
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Oh Woong
Department Of Cardiology Cardiovascular Center Korea University Hospital
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Park Mi
Department Of Biology College Of Science Yonsei University
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Shim Wan
Cardiovascular Center Korea University Anam Hospital
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Kim Young-hoon
Division Of Cardiology Cardiovascular Center
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Lim Do-sun
Korea University Anam Hospital
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Shim Wan
Korea University Hospital
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Shin Sung
Department of Applied Physics, Korea University, Chungnam 339-700, Korea
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