Document Detail

Augmentation of pulmonary vein backflow velocity during left atrial contraction: a novel phenomenon responsible for progression of atrial fibrillation in hypertensive patients.
MedLine Citation:
PMID:  17627107     Owner:  NLM     Status:  MEDLINE    
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.
Toru Maruyama; Toshisuke Kishikawa; Hiroyuki Ito; Yoshikazu Kaji; Yasushi Sasaki; Yasushi Ishihara
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Publication Detail:
Type:  Journal Article     Date:  2007-07-10
Journal Detail:
Title:  Cardiology     Volume:  109     ISSN:  1421-9751     ISO Abbreviation:  Cardiology     Publication Date:  2008  
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  33-40     Citation Subset:  IM    
Copyright Information:
(c) 2007 S. Karger AG, Basel
Department of Medicine, Kyushu University, Fukuoka, Japan.
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MeSH Terms
Atrial Fibrillation / etiology,  pathology,  physiopathology*
Atrial Function, Left / physiology*
Blood Flow Velocity / physiology
Heart Atria / pathology
Hypertension / complications,  pathology,  physiopathology*
Middle Aged
Pulmonary Veins / physiopathology*

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