Impact of Left Atrial Sphericity Index on the Outcome of Catheter Ablation for Atrial Fibrillation

Journal of Cardiovascular Translational Research - Tập 14 - Trang 912-920 - 2021
Jiaran Shi1, Shuangbin Xu1, Leiyang Chen1, Bifeng Wu1, Kun Yang1, Shi Chen2, Dongchen Zhou1, Biqi Zhang1, Tianming Xuan1, Xiaosheng Hu1
1Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
2Department of Geriatric, ShuLan (HangZhou) Hospital, Hangzhou, China

Tóm tắt

Left atrial sphericity index (LASI) is one significant geometric remodeling parameter to evaluate the prognosis of atrial fibrillation (AF). We aimed to determine whether transthoracic echocardiography (TTE)–derived LASI may help predict the outcomes following AF radiofrequency catheter ablation (RFCA). This prospective study enrolled 190 consecutive AF patients who underwent TTE 24 h before RFCA. LASI was calculated as the ratio of left atrial maximum volume to spherical volume. After 1-year follow-up, 56 patients (29.5%) relapsed. Multivariate Cox regression showed that LASI (hazard ratio = 1.48, 95% Cl 1.15–1.92, P = 0.003) was an independent predictor of AF recurrence. Stratifying patients into four subgroups with different LAVI showed that high LASI value indicated a high risk of recurrence, especially in patients with mildly and moderately enlarged atria (the recurrence rate was 0% vs. 26.3%, P = 0.049; 9.5% vs. 40.9%, P = 0.018, respectively). In conclusion, TTE-derived LASI may be useful to predict AF recurrence after RFCA.

Tài liệu tham khảo

Wang, T. J., Larson, M. G., Levy, D., Vasan, R. S., Leip, E. P., Wolf, P. A., et al. (2003). Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality - the Framingham heart study. Circulation, 107, 2920–2925. Freedman, B., Potpara, T. S., & Lip, G. Y. H. (2016). Stroke prevention in atrial fibrillation. Lancet, 388, 806–817. Calkins, H., Hindricks, G., Cappato, R., Kim, Y.-H., Saad, E. B., Aguinaga, L., et al. (2018). 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace, 20, E1–E160. den Uijl, D. W., Delgado, V., Tops, L. F., Ng, A. C. T., Boersma, E., Trines, S. A., et al. (2011). Natriuretic peptide levels predict recurrence of atrial fibrillation after radiofrequency catheter ablation. American Heart Journal, 161. Bisbal, F., Guiu, E., Calvo, N., Marin, D., Berruezo, A., Arbelo, E., et al. (2013). Left atrial sphericity: a new method to assess atrial remodeling. Impact on the outcome of atrial fibrillation ablation. Journal of Cardiovascular Electrophysiology, 24, 752–759. Moon, J., Lee, H.-J., Yu, J., Pak, H.-N., Ha, J.-W., Lee, M.-H., et al. (2017). Prognostic implication of left atrial sphericity in atrial fibrillation patients undergoing radiofrequency catheter ablation. Pace-Pacing And Clinical Electrophysiology, 40, 713–720. Osmanagic, A., Moller, S., Osmanagic, A., Sheta, H. M., Vinther, K. H., & Egstrup, K. (2016). Left atrial sphericity index predicts early recurrence of atrial fibrillation after direct-current cardioversion: an echocardiographic study. Clinical Cardiology, 39, 406–412. Nakamori, S., Ngo, L. H., Tugal, D., Manning, W. J., & Nezafat, R. (2018). Incremental value of left atrial geometric remodeling in predicting late atrial fibrillation recurrence after pulmonary vein isolation: a cardiovascular magnetic resonance study. Journal of the American Heart Association, 7. Lang, R. M., Badano, L. P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., et al. (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28, 1–U170. Sung, S.-H., Chang, S.-L., Hsu, T.-L., Yu, W.-C., Tai, C.-T., Lin, Y.-J., et al. (2008). Do the left atrial substrate properties correlate with the left atrial mechanical function? A novel insight from the electromechanical study in patients with atrial fibrillation. Journal of Cardiovascular Electrophysiology, 19, 165–171. Sanfilippo, A. J., Abascal, V. M., Sheehan, M., Oertel, L. B., Harrigan, P., Hughes, R. A., et al. (1990). Atrial enlargement as a consequence of atrial-fibrillation - a prospective echocardiographic study. Circulation, 82, 792–797. Burstein, B., & Nattel, S. (2008). Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. Journal of the American College of Cardiology, 51, 802–809. Reant, P., Lafitte, S., Jais, P., Serri, K., Weerasooriya, R., Hocini, M., et al. (2005). Reverse remodeling of the left cardiac chambers after catheter ablation after 1 year in a series of patients with isolated atrial fibrillation. Circulation, 112, 2896–2903. Njoku, A., Kannabhiran, M., Arora, R., Reddy, P., Gopinathannair, R., Lakkireddy, D., et al. (2018). Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis. Europace, 20, 33–42. Kishima, H., Mine, T., Takahashi, S., Ashida, K., Ishihara, M., & Masuyama, T. (2018). Left atrial ejection force predicts the outcome after catheter ablation for paroxysmal atrial fibrillation. Journal of Cardiovascular Electrophysiology, 29, 264–271. Levine, Y. C., Matos, J., Rosenberg, M. A., Manning, W. J., Josephson, M. E., & Buxton, A. E. (2016). Left ventricular sphericity independently predicts appropriate implantable cardioverter-defibrillator therapy. Heart Rhythm, 13, 490–497. Nakamori, S., Ismail, H., Ngo, L. H., Manning, W. J., & Nezafat, R. (2017). Left ventricular geometry predicts ventricular tachyarrhythmia in patients with left ventricular systolic dysfunction: a comprehensive cardiovascular magnetic resonance study. Journal of Cardiovascular Magnetic Resonance, 19. Bisbal, F., Alarcon, F., Ferrero-de-Loma-Osorio, A., Jose Gonzalez-Ferrer, J., Alonso, C., Pachon, M., et al. (2018). Left atrial geometry and outcome of atrial fibrillation ablation: results from the multicentre LAGO-AF study. European Heart Journal Cardiovascular Imaging, 19, 1002–1009. Steinberg, B. A., & Piccini, J. P. (2013). Left atrial remodeling: shape before size? Journal of Cardiovascular Electrophysiology, 24, 760–761. Hoffmeister, P. S., Chaudhry, G. M., Mendel, J., Almasry, I., Tahir, S., Marchese, T., et al. (2007). Evaluation of left atrial and posterior mediastinal anatomy by multidetector helical computed tomography imaging: relevance to ablation. Journal of Interventional Cardiac Electrophysiology, 18, 217–223. Buechel, R. R., Stephan, F. P., Sommer, G., Bremerich, J., Zellweger, M. J., & Kaufmann, B. A. (2013). Head-to-head comparison of two-dimensional and three-dimensional echocardiographic methods for left atrial chamber quantification with magnetic resonance imaging. Journal of the American Society of Echocardiography, 26, 428–435.