Incremental value of diastolic wall strain in predicting heart failure events in patients with atrial fibrillation

This study aims to assess DWS as a predictor of HF in AF patients with preserved ejection fraction. We analysed a prospective database of AF patients undergoing transthoracic echocardiography. AF patients with reduced left ventricular ejection fraction (<  50%), posterior wall motion abnormality, hypertrophic cardiomyopathy, valvular heart disease, pericardial disease, congenital heart disease, or history of pacemaker/implantable cardioverter-defibrillator implantation or cardiac surgery were excluded. The study followed patients until HF developme nt, death, or last visit. Follow-up for patients who underwent catheter ablation was censored on the date of their procedure. HF was ascertained based on the Framingham criteria. DWS was calculated using a validated formula: DWS = (PWs -PWd)/PWs, where PWs is the posterior wall thickness at end-syst ole and PWd is the posterior wall thickness at end-diastole. Among 411 study patients (mean age 69.6 years, 66% men), 20 (5%) was underwent catheter ablation and 57 (14%) developed HF during a mean follow-up of 82 months. Cox-proportional hazards demonstrated that low DWS (≤ 0.33) significantly predicted HF events (hazard ratio [HR] 3.28, 95% confidence interval [CI]) 1.81–5.94,P <  0.0001), independent of age (per 10 years; HR 1.99, 95% CI 1.35–2.93,P <  0.001), indexed left ventricular mass (per 10 g/m2; HR 1.16, 95% CI 1.05 –1.27,P <  0.01), and indexed left atrial volume (per 10 mL/m2; HR 1.14, 9...
Source: Heart and Vessels - Category: Cardiology Source Type: research