Augmentation of pulmonary vein backflow velocity during left atrial contraction: A novel phenomenon responsible for progression of atrial fibrillation in hypertensive patients

Toru Maruyama, Toshisuke Kishikawa, Hiroyuki Ito, Yoshikazu Kaji, Yasushi Sasaki, Yasushi Ishihara

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia showing disease progression. However, echocardiographic prediction of such progression remains incomplete. This study aimed to identify echocardiographic predictors of AF progression in hypertensive patients. Methods: Hypertensive patients with paroxysmal AF were divided into two groups: patients with AF which became permanent (group A; n = 13) and those with AF which remained paroxysmal (group B; n = 46) during the same follow-up period (8.0 ± 2.4 years). Clinical baselines showed no significant differences except for age. Transthoracic echocardiography was recorded 1-2 weeks after termination of the first-detected paroxysms of AF. Results: Echocardiography showed greater left atrial (LA) dimension (p = 0.023) and late diastolic pulmonary vein (PV) backflow velocity (p < 0.001), and a lower LA fractional shortening (p = 0.008) in group A than in group B. Multilogistic regression analysis demonstrated that augmented PV backflow (p = 0.007) and reduced LA fractional shortening (p = 0.032) were independent predictors of the progression of AF. The receiver-operating characteristic curve demonstrated that PV backflow augmentation is the best predictor of future AF perpetuation. Conclusion: PV backflow leading to cyclic stretching of PV musculature contributes to AF progression.

Original languageEnglish
Pages (from-to)33-40
Number of pages8
JournalCardiology
Volume109
Issue number1
DOIs
Publication statusPublished - Dec 1 2007

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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