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Article: Reversible impairment of left and right ventricular systolic and diastolic function during short-lasting atrial fibrillation in patients with an implantable atrial defibrillator: A tissue doppler imaging study

TitleReversible impairment of left and right ventricular systolic and diastolic function during short-lasting atrial fibrillation in patients with an implantable atrial defibrillator: A tissue doppler imaging study
Authors
Issue Date2001
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2001, v. 24 n. 6, p. 979-988 How to Cite?
AbstractAF with a fast ventricular response may cause ventricular mechanical impairment, though whether short-lasting AF with satisfactory rate control may affect ventricular function is unknown. This study investigated if prompt cardioversion by an implantable atrial defibrillator (IAD) may prevent left (LV) and right ventricular (RV) systolic and diastolic dysfunction. Ten patients (mean age 61 ± 9 years, 8 men) with paroxysmal AF without structural heart disease who received an IAD were studied by echocardiography and tissue Doppler imaging (TDI) for both ventricles. Measurements were made during baseline sinus rhythm and at 1-minute, 20-minute, 4-hour, and 1-week postcardioversion of an episode of spontaneous AF. The occurrence AF and the ventricular rate were monitored at 2-hour intervals by the device. There were 50 episodes AF with a mean duration of 8.8 ± 8.9 days (2 hours to 37 days). There was no difference in M-mode measured L V fractional shortening and ejection fraction between baseline sinus rhythm and after cardioversion, However, the TDI derived myocardial systolic velocity (TDI-S) was significantly lower at 1-minute postcardioversion and was normalized at 1 week in both LVs (baseline: 5.7 ± 1.8, 1 minute: 4.2 ± 1.0, 20 minutes: 4.3 ± 0.9, 4 hours: 4.8 ± 1.0, 1 week: 5.5 ± 1.8 cm/s; P < 0.005 when comparing 1 minute and 20 minutes to baseline; P < 0.05 when comparing 4 hour to baseline) and RV (baseline: 10.4 ± 2.1, 1 minute: 7.8 ± 1.4, 20 minutes: 8.1 ± 1.2, 4 hours: 9.2 ± 1.5, 1 week: 10.0 ± 2.0 cm/s; P < 0.005 when comparing 1 minute, 20 minutes, and 4 hours to baseline). For diastolic function, transmittal Doppler study showed a decrease in early filling velocity at I minute (P < 0.05) and 20 minutes (P < 0.005), which was normalized at 4 hours. There was no change in transtricuspid Doppler flow. However, TDI derived myocardial early filling velocity was decreased in the LV (baseline: 6.0 ± 2.8, 1 minute: 5.4 ± 2.3, 20 minutes: 5.4 ± 2.1, 4 hours: 6.1 ± 2.2, 1 week: 5.8 ± 1.7 cm/s; P < 0.05 when comparing 1 minute and 20 minutes to baseline) and RV (baseline: 8.9 ± 3.5, 1 minute: 7.9 ± 3.3, 20 minutes: 8.1 ± 3.3, 4 hours: 8.5 ± 2.9, 1 week: 8.4 ± 3.5 cm/s; P < 0.05 when comparing 1 minute to baseline). AF of a longer duration (> 48 hours) resulted in a more depressed TDI-S in LV (> 48 hours: 4.2 ± 1.0, ≤ 48 hours: 5.3 ± 1.3 cm/s; P < 0.01). Shocks in sinus rhythm did not affect uny of the above echocardiographic parameters. Therefore, despite adequate rate control, short-lasting AF impairs systolic and diastolic function in both ventricles, which improves gradually after cardioversion. Early restoration of sinus rhythm by an IAD minimizes ventricular dysfunction. TDI is a sensitive tool to assess early systolic and diastolic dysfunction.
Persistent Identifierhttp://hdl.handle.net/10722/162481
ISSN
2015 Impact Factor: 1.156
2015 SCImago Journal Rankings: 0.662
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYu, CMen_US
dc.contributor.authorWang, Qen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorLeung, SKen_US
dc.contributor.authorLee, KLFen_US
dc.contributor.authorTsang, Ven_US
dc.contributor.authorAyers, Gen_US
dc.date.accessioned2012-09-05T05:20:24Z-
dc.date.available2012-09-05T05:20:24Z-
dc.date.issued2001en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2001, v. 24 n. 6, p. 979-988en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/162481-
dc.description.abstractAF with a fast ventricular response may cause ventricular mechanical impairment, though whether short-lasting AF with satisfactory rate control may affect ventricular function is unknown. This study investigated if prompt cardioversion by an implantable atrial defibrillator (IAD) may prevent left (LV) and right ventricular (RV) systolic and diastolic dysfunction. Ten patients (mean age 61 ± 9 years, 8 men) with paroxysmal AF without structural heart disease who received an IAD were studied by echocardiography and tissue Doppler imaging (TDI) for both ventricles. Measurements were made during baseline sinus rhythm and at 1-minute, 20-minute, 4-hour, and 1-week postcardioversion of an episode of spontaneous AF. The occurrence AF and the ventricular rate were monitored at 2-hour intervals by the device. There were 50 episodes AF with a mean duration of 8.8 ± 8.9 days (2 hours to 37 days). There was no difference in M-mode measured L V fractional shortening and ejection fraction between baseline sinus rhythm and after cardioversion, However, the TDI derived myocardial systolic velocity (TDI-S) was significantly lower at 1-minute postcardioversion and was normalized at 1 week in both LVs (baseline: 5.7 ± 1.8, 1 minute: 4.2 ± 1.0, 20 minutes: 4.3 ± 0.9, 4 hours: 4.8 ± 1.0, 1 week: 5.5 ± 1.8 cm/s; P < 0.005 when comparing 1 minute and 20 minutes to baseline; P < 0.05 when comparing 4 hour to baseline) and RV (baseline: 10.4 ± 2.1, 1 minute: 7.8 ± 1.4, 20 minutes: 8.1 ± 1.2, 4 hours: 9.2 ± 1.5, 1 week: 10.0 ± 2.0 cm/s; P < 0.005 when comparing 1 minute, 20 minutes, and 4 hours to baseline). For diastolic function, transmittal Doppler study showed a decrease in early filling velocity at I minute (P < 0.05) and 20 minutes (P < 0.005), which was normalized at 4 hours. There was no change in transtricuspid Doppler flow. However, TDI derived myocardial early filling velocity was decreased in the LV (baseline: 6.0 ± 2.8, 1 minute: 5.4 ± 2.3, 20 minutes: 5.4 ± 2.1, 4 hours: 6.1 ± 2.2, 1 week: 5.8 ± 1.7 cm/s; P < 0.05 when comparing 1 minute and 20 minutes to baseline) and RV (baseline: 8.9 ± 3.5, 1 minute: 7.9 ± 3.3, 20 minutes: 8.1 ± 3.3, 4 hours: 8.5 ± 2.9, 1 week: 8.4 ± 3.5 cm/s; P < 0.05 when comparing 1 minute to baseline). AF of a longer duration (> 48 hours) resulted in a more depressed TDI-S in LV (> 48 hours: 4.2 ± 1.0, ≤ 48 hours: 5.3 ± 1.3 cm/s; P < 0.01). Shocks in sinus rhythm did not affect uny of the above echocardiographic parameters. Therefore, despite adequate rate control, short-lasting AF impairs systolic and diastolic function in both ventricles, which improves gradually after cardioversion. Early restoration of sinus rhythm by an IAD minimizes ventricular dysfunction. TDI is a sensitive tool to assess early systolic and diastolic dysfunction.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAtrial Fibrillation - Physiopathology - Therapy - Ultrasonographyen_US
dc.subject.meshDefibrillators, Implantableen_US
dc.subject.meshDiastoleen_US
dc.subject.meshEchocardiography, Doppleren_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart - Physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshSystoleen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshVentricular Function, Leften_US
dc.subject.meshVentricular Function, Righten_US
dc.titleReversible impairment of left and right ventricular systolic and diastolic function during short-lasting atrial fibrillation in patients with an implantable atrial defibrillator: A tissue doppler imaging studyen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1460-9592.2001.00979.x-
dc.identifier.pmid11449595-
dc.identifier.scopuseid_2-s2.0-0034921523en_US
dc.identifier.hkuros60564-
dc.identifier.hkuros100783-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034921523&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume24en_US
dc.identifier.issue6en_US
dc.identifier.spage979en_US
dc.identifier.epage988en_US
dc.identifier.isiWOS:000169274500011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridYu, CM=7404976646en_US
dc.identifier.scopusauthoridWang, Q=7406919551en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLeung, SK=7202044902en_US
dc.identifier.scopusauthoridLee, KLF=16750539400en_US
dc.identifier.scopusauthoridTsang, V=7005694255en_US
dc.identifier.scopusauthoridAyers, G=7102015157en_US

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