Background: Atrial conduction delay and its association with left atrial dimension, left atrial pressure and left ventricular (LV) diastolic dysfunction in patients at risk of atrial fibrillation (AF) may be assessed by high-resolution electrocardiography of P wave.
Objectives: To determine how left atrial size, left atrial pressure and LV diastolic dysfunction, measured noninvasively by transthoracic echocardiography, influence atrial conduction time.
Methods: Signal-averaged electrocardiography of P wave and echocardiogram were performed on 70 patients (average age of 63+/-10 years; 37 male and 33 female), divided into three groups: group A, patients with paroxysmal AF (n=29); group B, patients with type 2 diabetes mellitus and arterial hypertension, but without AF (n=23); and group C, healthy control patients (n=18). Standard statistical methods were used.
Results: Filtered P wave duration, measured by signal-averaged electrocardiography, was significantly prolonged in group A and group B compared with control group C (138+/-12 ms and 125+/-9 ms versus 117+/-8 ms; P = 0.001 and P = 0.01, respectively). Left atrial diameter, area and volume were significantly increased in group A compared with group C (P = 0.01, P = 0.05 and P = 0.001, respectively), but no significant differences were found in these dimensions between group B and group C. Left atrial pressure, determined with the Doppler echocardiographic parameter ratio of early diastolic transmitral velocity to mitral annular early diastolic velocity, was significantly higher in group A, as well in group B, than group C (P = 0.05, P = 0.01). As well, impaired LV relaxation was present more often in group A (42%) and group B (50%).
Conclusion: Atrial conduction delay in patients at risk of AF (patients with diabetes and hypertension in group B) was associated with increased left atrial pressure and impaired LV relaxation. Patients with paroxysmal AF (group A) presented left atrial dilation, increased left atrial pressure and impaired LV relaxation, and these factors were associated with more significantly prolonged atrial conduction in group A than in group B.
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J Cardiovasc Med (Hagerstown)
February 2025
Division of Cardiology, Department of Systems Medicine, Tor Vergata University, Rome.
Atrial cardiomyopathy (AC) has been defined by the European Heart Rhythm Association as "Any complex of structural, architectural, contractile, or electrophysiologic changes in the atria with the potential to produce clinically relevant manifestations".1 The left atrium (LA) plays a key role in maintaining normal cardiac function; in fact atrial dysfunction has emerged as an essential determinant of outcomes in different clinical scenarios, such as valvular diseases, heart failure (HF), coronary artery disease (CAD) and atrial fibrillation (AF). A comprehensive evaluation, both anatomical and functional, is routinely performed in cardiac imaging laboratories.
View Article and Find Full Text PDFBlood Press
January 2025
Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Kraków, Poland.
Purpose: Ventricular-arterial coupling (VAC) is a crucial concept in cardiovascular physiology, representing the dynamic interaction between the left ventricle and the arterial system. This comprehensive literature review explores the changes in VAC with aging and various cardiovascular diseases (CVDs).
Materials And Methods: This literature review covers studies on changes in VAC with age and common CVDs such as arterial hypertension, atrial fibrillation, heart failure with preserved and reduced ejection fraction and aortic stenosis.
Iran J Med Sci
December 2024
Cardiovascular Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Background: The relationship between diastolic function parameters and the severity of coronary artery disease (CAD) is controversial. This study aimed to determine the relationship between left ventricular diastolic function and the severity of CAD.
Methods: This cross-sectional study included 63 patients with Ischemic heart disease (IHD) or those suspected of having IHD, who underwent angiography.
Int J Cardiol Heart Vasc
February 2025
Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan.
Background: The optimal imaging modality for selecting the device size in patients with atrial fibrillation undergoing one-stop left atrial appendage occlusion (LAAO) with concomitant pulmonary vein isolation (PVi) remains undefined. We compared preprocedural 3-dimensional computed tomography (3D CT) with intra-procedural transesophageal echocardiography (TEE) and left atrial appendage (LAA) angiography in guiding one-stage PVi and LAAO.
Methods: We measured the LAA ostium diameter using an interactive 3D CT system with a central line-based approach and compared these measurements with those from intra-procedural TEE and angiography, and the actual device size.
Cureus
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Internal Medicine, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT.
Raynaud's phenomenon (RP) is characterized by episodic vasospasm of the small blood vessels, primarily affecting the fingers and toes. Management includes lifestyle modifications, pharmacological treatments, and in severe cases, surgical interventions. Here we report a case of an 80-year-old male patient with a history of hypertension, dyslipidemia, obesity, and atrial fibrillation who presented to the emergency department with edema, cyanosis, and intense pain in the fingers of both hands following a mild COVID-19 infection (no dyspnea or hypoxemia).
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