Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2014  |  Volume : 24  |  Issue : 1  |  Page : 10-17

External cardioversion of atrial fibrillation causes an early improvement of cardiac performance: A longitudinal strain analysis study


1 Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy
2 ESAOTE SpA, Florence, Italy
3 Department of Experimental and Clinical Medicine, Electrophysiology Unit and School of Cardiology, University of Florence and AOU Careggi, Florence, Italy
4 Department of Cardiology and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, The Netherlands

Correspondence Address:
Stefano Fumagalli
Department of Experimental and Clinical Medicine, Division of Geriatric Cardiology and Medicine, Research Unit of Medicine of Aging, University of Florence and AOU Careggi, Florence, Italy

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2211-4122.131987

Rights and Permissions

Introduction: Atrial fibrillation (AF) is often associated with heart failure. Several studies have demonstrated that resumption of sinus rhythm (SR) improves cardiac output in the long-term. Aims of this study were to evaluate the acute variations of left ventricular (LV) performance, following successful external cardioversion (ECV) of persistent AF using longitudinal strain (LSt) analysis, and the influence of inflammation. Materials and Methods: We enrolled 48 patients with AF (age: 73 ± 12 years, men: 83.3%). A standard transthoracic echocardiographic evaluation was performed before the procedure and 6 h later; this included the analysis of LV endocardial peak LSt, a measure of myocardial deformation. In the last 32 patients, plasma concentration of interleukin-6 (IL-6) was also determined. Results: Restoration of SR led to the decrease of heart rate (HR) (74 ± 21 vs 64 ± 10 bpm, P < 0.001) and LV end-systolic volume (30 ± 16 vs 27 ± 17 mL/m 2 , P = 0.001), and to the increase of LV end-diastolic volume (LVEDV) (56 ± 20 vs 60 ± 21 mL/m 2 , P = 0.036) and ejection fraction (EF) (48 ± 10 vs 57 ± 11%, P < 0.001). Peak LSt improved in 43 (89.6%) patients (-12.9 ± 3.3 vs -18.0 ± 4.7%, P < 0.001). Multivariate analysis (R = 0.729, P < 0.001) showed that strain changes were directly correlated with basal HR and the appearance of atrial mechanical activity and inversely correlated with corrected thyroid dysfunction, LVEDV and the presence of a permanent pacemaker. Higher levels of IL-6 negatively affected LV performance improvement. Conclusions: Effective ECV of AF determines a significant and fast improvement of LV performance, which is readily captured by LSt analysis. Inflammatory status may impact the response to SR restoration.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2693    
    Printed97    
    Emailed0    
    PDF Downloaded96    
    Comments [Add]    
    Cited by others 2    

Recommend this journal