Left Ventricular Diastolic Indices and Their Impact on Outcomes in Patients with Recently Diagnosed Atrial Fibrillation

Nobuhiro Ikemura, Koki Nakanishi, John A. Spertus, Carolyn S.P. Lam, Takehiro Kimura, Yoshinori Katsumata, Taishi Fujisawa, Ikuko Ueda, Takahiro Ohki, Keiichi Fukuda, Seiji Takatsuki, Shun Kohsaka

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Early identification of atrial fibrillation (AF) patients at risk for heart failure (HF) remains critical for improving their outcomes. We aimed to investigate whether indices of left ventricular diastolic dysfunction (LVDD) can stratify AF patients without clinical history of HF. Methods: We extracted 1775 patients’ data from a prospective cohort that consecutively recruited recently recognized AF patients with ejection fraction ≥50%. We categorized patients as LVDD grade 0 (none) to 3 (severe) based on mitral deceleration time and E/e’ per the American Society of Echocardiography recommendation. The primary outcome was a composite of all-cause death, stroke, and HF hospitalization during the 2-year follow-up. We also investigated the Atrial Fibrillation Effects on QualiTy-of-Life (AFEQT) scores. Results: Overall, 857 (48.3%) had mild or higher LVDD. Incidence of primary outcomes increased in parallel with LVDD grading (1.8%, 2.8%, 6.5%, and 8.1% for grades 0–3, respectively, p < 0.001), and the presence of grade 3 LVDD was an independent predictor of the primary outcome (adjusted HR 2.28 (vs. grade 0), 95%CI 1.13–4.60). Furthermore, patients with LVDD had lower AFEQT scores at the enrollment and 1-year follow-up. Conclusions: LVDD indices were associated with adverse clinical outcomes and patients’ perceived health status in a recently diagnosed AF cohort without HF.

Original languageEnglish
Article number5732
JournalJournal of Clinical Medicine
Volume11
Issue number19
DOIs
Publication statusPublished - 2022 Oct

Keywords

  • atrial fibrillation
  • diastolic dysfunction
  • heart failure
  • quality of life

ASJC Scopus subject areas

  • Medicine(all)

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