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. 2023 Jun 20;13(6):1421.
doi: 10.3390/life13061421.

The Impact of Atrial Fibrillation on All Heart Chambers Remodeling and Function in Patients with Dilated Cardiomyopathy-A Two- and Three-Dimensional Echocardiography Study

Maria L Iovănescu  1   2 , Diana R Hădăreanu  2 , Despina M Toader  2 , Cristina Florescu  1   3 , Octavian Istrătoaie  1   2 , Ionuţ Donoiu  1   2 , Constantin Militaru  1   2
Affiliations

The Impact of Atrial Fibrillation on All Heart Chambers Remodeling and Function in Patients with Dilated Cardiomyopathy-A Two- and Three-Dimensional Echocardiography Study

Maria L Iovănescu et al. Life (Basel). .

Abstract

Atrial fibrillation is frequently seen in patients with dilated cardiomyopathy (DCM), and its presence impacts the function of the heart, with clinical and prognostic consequences. In this prospective single-center study, we aimed to assess the impact of atrial fibrillation on cardiac structure and function, using comprehensive two- and three-dimensional echocardiography. We included 41 patients with DCM and persistent or permanent atrial fibrillation (38 male, age 58.8 ± 11 years), as well as 47 patients with DCM and in sinus rhythm (35 male, age 58 ± 12.5 years). Cardiac chambers and mitral and tricuspid valves' structure and function were assessed via standard two-dimensional, speckle-tracking, and three-dimensional echocardiography (3DE). Patients with DCM and atrial fibrillation had a more impaired left ventricular global longitudinal strain, higher 3DE left atrial volumes, and reduced function compared to patients in sinus rhythm in the presence of similar left ventricle volumes. Mitral annulus configuration was altered in atrial fibrillation DCM patients. Also, right heart volumes were larger, with more severe atrial and ventricular dysfunction, despite similar estimated pulmonary artery pressures and severity of tricuspid regurgitation. Using advanced echocardiography techniques, we demonstrated that atrial fibrillation induces significant remodeling in all heart chambers.

Keywords: arrhythmia; cardiomyopathy; imaging.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
LVGLS with a bull’s eye pattern representation in (A). AF—patients or (B) SR—patients. Abbreviations: LVGLS—left ventricular global longitudinal strain, SR—sinus rhythm, AF—atrial fibrillation.
Figure 2
Figure 2
RVFWLS calculation in a patient with (A) SR or (B) AF. Abbreviations: RVFWLS—right ventricular free wall longitudinal strain; SR, AF—same as in Figure 1.
Figure 3
Figure 3
LAS calculation in a patient with (A) AF or (B) SR. Abbreviations: LAS—left atrial strain; AF, SR—same as in Figure 1.
Figure 4
Figure 4
LV volumes and EF calculation via 3DE in a patient with (A) AF or (B) SR. Abbreviations: LV—left ventricular; EF—ejection fraction; 3DE—three-dimensional echocardiography; SR, AF—same as in Figure 1.
Figure 5
Figure 5
RV volumes and EF calculation via 3DE in a patient with (A) AF or (B) SR. Abbreviations: RV—right ventricular; EF, 3DE—same as in Figure 4; SR, AF—same as in Figure 1.
Figure 6
Figure 6
LA volumes and function via 3DE in a patient with (A) SR or (B). AF; Abbreviations: LA—left atrial; 3DE—same as in Figure 4; SR, AF—same as in Figure 1.
See this image and copyright information in PMC

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