Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 30;10(17):3894.
doi: 10.3390/jcm10173894.

Cardiac Remodeling and Diastolic Dysfunction in Paroxysmal Atrial Fibrillation

Nathalie Noirclerc  1 , Olivier Huttin  1 , Christian de Chillou  1 , Christine Selton-Suty  1 , Laura Fillipetti  1 , Jean Marc Sellal  1 , Erwan Bozec  2 , Erwan Donal  3 , Zohra Lamiral  2 , Masatake Kobayashi  2 , João Pedro Ferreira  2 , Patrick Rossignol  2 , Nicolas Girerd  2
Affiliations

Cardiac Remodeling and Diastolic Dysfunction in Paroxysmal Atrial Fibrillation

Nathalie Noirclerc et al. J Clin Med. .

Abstract

Background: Atrial fibrillation (AF) leads to the development of cardiac remodeling/diastolic dysfunction and vice versa. We intended to determine whether cardiac remodeling/diastolic dysfunction is present at early stages of AF.

Methods: We studied 175 patients with paroxysmal AF, compared with 175 matched control subjects, who had available echocardiography data to investigate the association between echocardiographic variables and AF from the STANISLAS cohort.

Results: In this study (mean age 55 years; 70.3% male), patients with paroxysmal AF had greater left ventricular mass compared to matched controls (p < 0.05). Patients with paroxysmal AF were also likely to have larger left atrial volume and a higher peak tricuspid regurgitation velocity, leading to higher prevalence (though <10% in the AF group) of diastolic dysfunction (all-p < 0.05). Multivariable conditional logistic regression models showed that paroxysmal AF was significantly associated with increased left ventricular mass and left atrial enlargement (all-p < 0.001), but not with e' and deceleration time of E wave (all-p > 0.1).

Conclusions: Left ventricular mass and left atrial enlargement rather than diastolic dysfunction (as evaluated by echocardiography) were associated with paroxysmal AF irrespective of body mass index, blood pressure and renal function. These findings suggest that cardiac remodeling may occur very early in the natural history of AF.

Keywords: atrial fibrillation; diastolic dysfunction; echocardiography; heart failure; left atrial remodeling.

PubMed Disclaimer

Conflict of interest statement

Rossignol reports grants and personal fees from AstraZeneca, Bayer, CVRx, Fresenius, and Novartis, personal fees from Grunenthal, Servier, Stealth Peptides, Vifor Fresenius Medical Care Renal Pharma, Idorsia, NovoNordisk, Ablative Solutions, G3P, Corvidia, Relypsa, and is the cofounder of CardioRenal, a company developing a telemonitoring loop in heart failure (including potassium measurements). Girerd reports grants and personal fees from AstraZeneca, Bayer, Boehringer, Lilly, Novartis and Vifor.

References

    1. Ferreira J.P., Santos M. Heart failure and atrial fibrillation: From basic science to clinical practice. Int. J. Mol. Sci. 2015;16:3133–3147. doi: 10.3390/ijms16023133. - DOI - PMC - PubMed
    1. Mazzone C., Cioffi G., Di Nora C., Barbati G., Guidetti F., Faggiano P., Gaibazzi N., Faganello G., Borca E.C., Di Lenarda A. Prognostic role of cardiac calcifications in primary prevention: A powerful marker of adverse outcome highly dependent on underlying cardiac rhythm. Int. J. Cardiol. 2018;258:262–268. doi: 10.1016/j.ijcard.2018.01.101. - DOI - PubMed
    1. Santhanakrishnan R., Wang N., Larson M.G., Magnani J.W., McManus D.D., Lubitz S.A., Ellinor P.T., Cheng S., Vasan R.S., Lee D.S., et al. Atrial Fibrillation Begets Heart Failure and Vice Versa: Temporal Associations and Differences in Preserved Versus Reduced Ejection Fraction. Circulation. 2016;133:484–492. doi: 10.1161/CIRCULATIONAHA.115.018614. - DOI - PMC - PubMed
    1. Huttin O., Fraser A.G., Coiro S., Bozec E., Selton-Suty C., Lamiral Z., Frikha Z., Rossignol P., Zannad F., Girerd N. Impact of Changes in Consensus Diagnostic Recommendations on the Echocardiographic Prevalence of Diastolic Dysfunction. J. Am. Coll. Cardiol. 2017;69:3119–3121. doi: 10.1016/j.jacc.2017.04.039. - DOI - PubMed
    1. Verdugo-Marchese M., Coiro S., Selton-Suty C., Kobayashi M., Bozec E., Lamiral Z., Venner C., Zannad F., Rossignol P., Girerd N., et al. Left ventricular myocardial deformation pattern, mechanical dispersion, and their relation with electrocardiogram markers in the large population-based STANISLAS cohort: Insights into electromechanical coupling. Eur. Heart J. Cardiovasc. Imaging. 2020;21:1237–1245. doi: 10.1093/ehjci/jeaa148. - DOI - PubMed

LinkOut - more resources