CLINICAL STUDY: CLINICAL APPLICATION OF ECHOCARDIOGRAPHIC FINDINGS
Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women
Teresa S. M. Tsang, MD, FACC*,*,
Bernard J. Gersh, MB, ChB, DPhil, FACC*,
Christopher P. Appleton, MD ,
A. Jamil Tajik, MD, FACC*,
Marion E. Barnes, MS*,
Kent R. Bailey, PhD ,
Jae K. Oh, MD, FACC*,
Cynthia Leibson, PhD ,
Samantha C. Montgomery, MS and
James B. Seward, MD, FACC*
* Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
Section of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
Section of Clinical Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona, USA
Manuscript received February 20, 2002;
revised manuscript received May 15, 2002,
accepted July 15, 2002.
* Reprint requests and correspondence: Dr. Teresa S. M. Tsang, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, USA 55905.
tsang.teresa{at}mayo.edu
OBJECTIVES: The objective of this study was to determine whether diastolic dysfunction is associated with increased risk of nonvalvular atrial fibrillation (NVAF) in older adults with no history of atrial arrhythmia.
BACKGROUND: Few data exist regarding the relationship between diastolic function and NVAF.
METHODS: The clinical and echocardiographic characteristics of patients age  65 years who had an echocardiogram performed between 1990 and 1998 were reviewed. Exclusion criteria were history of atrial arrhythmia, stroke, valvular or congenital heart disease, or pacemaker implantation. Patients were followed up in their medical records to the last clinical visit or death for documentation of first AF.
RESULTS: Of 840 patients (39% men; mean [± SD] age, 75 ± 7 years), 80 (9.5%) developed NVAF over a mean (± SD) follow-up of 4.1 ± 2.7 years. Abnormal relaxation, pseudonormal, and restrictive left ventricular diastolic filling were associated with hazard ratios of 3.33 (95% confidence interval [CI], 1.5 to 7.4; p = 0.003), 4.84 (95% CI, 2.05 to 11.4; p < 0.001), and 5.26 (95% CI, 2.3 to 12.03; p < 0.001), respectively, when compared with normal diastolic function. After a number of adjustments, diastolic function profile remained incremental to history of congestive heart failure and previous myocardial infarction for prediction of NVAF. Age-adjusted Kaplan-Meier five-year risks of NVAF were 1%, 12%, 14%, and 21% for normal, abnormal relaxation, pseudonormal, and restrictive diastolic filling, respectively.
CONCLUSIONS: The presence and severity of diastolic dysfunction are independently predictive of first documented NVAF in the elderly.
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Abbreviations and Acronyms
| | AF | | atrial fibrillation | | CAD | | coronary artery disease | | CHF | | congestive heart failure | | DT | | deceleration time | | LA | | left atrium or left atrial | | LV | | left ventricle or left ventricular | | MI | | myocardial infarction | | NVAF | | nonvalvular atrial fibrillation |
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jep153v1.
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[PDF]
|
|
|
|
|
|
|
C B De Vos, B Weijs, H J G M Crijns, E C Cheriex, A Palmans, J Habets, M H Prins, R Pisters, R Nieuwlaat, and R G Tieleman
Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation
Heart,
May 1, 2009;
95(10):
835 - 840.
[Abstract]
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[PDF]
|
|
|
|
|
|
|
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Minimum vs. maximum left atrial volume for prediction of first atrial fibrillation or flutter in an elderly cohort: a prospective study
Eur J Echocardiogr,
March 1, 2009;
10(2):
282 - 286.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Benjamin, P.-S. Chen, D. E. Bild, A. M. Mascette, C. M. Albert, A. Alonso, H. Calkins, S. J. Connolly, A. B. Curtis, D. Darbar, et al.
Prevention of Atrial Fibrillation: Report From a National Heart, Lung, and Blood Institute Workshop
Circulation,
February 3, 2009;
119(4):
606 - 618.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Kaireviciute, A. Aidietis, and G. Y.H. Lip
Atrial fibrillation following cardiac surgery: clinical features and preventative strategies
Eur. Heart J.,
February 2, 2009;
30(4):
410 - 425.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Grewal, R. McKelvie, E. Lonn, P. Tait, J. Carlsson, M. Gianni, C. Jarnert, and H. Persson
BNP and NT-proBNP predict echocardiographic severity of diastolic dysfunction
Eur J Heart Fail,
March 1, 2008;
10(3):
252 - 259.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. J. Lester, A. J. Tajik, R. A. Nishimura, J. K. Oh, B. K. Khandheria, and J. B. Seward
Unlocking the Mysteries of Diastolic Function Deciphering the Rosetta Stone 10 Years Later.
J. Am. Coll. Cardiol.,
February 19, 2008;
51(7):
679 - 689.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N.-H. Pan, H.-M. Tsao, N.-C. Chang, Y.-J. Chen, and S.-A. Chen
Aging Dilates Atrium and Pulmonary Veins: Implications for the Genesis of Atrial Fibrillation
Chest,
January 1, 2008;
133(1):
190 - 196.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Arriagada, A. Berruezo, L. Mont, D. Tamborero, I. Molina, B. Coll-Vinent, B. Vidal, M. Sitges, P. Berne, J. Brugada, et al.
Predictors of arrhythmia recurrence in patients with lone atrial fibrillation
Europace,
January 1, 2008;
10(1):
9 - 14.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.-R. Neuberger, C. Mewis, D. J. van Veldhuisen, U. Schotten, I. C. van Gelder, M. A. Allessie, and M. Bohm
Management of atrial fibrillation in patients with heart failure
Eur. Heart J.,
November 1, 2007;
28(21):
2568 - 2577.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Jahangir, V. Lee, P. A. Friedman, J. M. Trusty, D. O. Hodge, S. L. Kopecky, D. L. Packer, S. C. Hammill, W.-K. Shen, and B. J. Gersh
Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation: A 30-Year Follow-Up Study
Circulation,
June 19, 2007;
115(24):
3050 - 3056.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Berruezo, D. Tamborero, L. Mont, B. Benito, J. M. Tolosana, M. Sitges, B. Vidal, G. Arriagada, F. Mendez, M. Matiello, et al.
Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation
Eur. Heart J.,
April 1, 2007;
28(7):
836 - 841.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. F. Mitchell, R. S. Vasan, M. J. Keyes, H. Parise, T. J. Wang, M. G. Larson, R. B. D'Agostino Sr, W. B. Kannel, D. Levy, and E. J. Benjamin
Pulse Pressure and Risk of New-Onset Atrial Fibrillation
JAMA,
February 21, 2007;
297(7):
709 - 715.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Gami, D. O. Hodge, R. M. Herges, E. J. Olson, J. Nykodym, T. Kara, and V. K. Somers
Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation
J. Am. Coll. Cardiol.,
February 6, 2007;
49(5):
565 - 571.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Benedetto, G. Melina, A. Roscitano, G. M. Ciavarella, E. Tonelli, and R. Sinatra
Clinical Utility of Tissue Doppler Imaging in Prediction of Atrial Fibrillation After Coronary Artery Bypass Grafting
Ann. Thorac. Surg.,
January 1, 2007;
83(1):
83 - 88.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al.
ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society
Europace,
September 1, 2006;
8(9):
651 - 745.
[Full Text]
[PDF]
|
|
|
|
|
|
|
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ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society
J. Am. Coll. Cardiol.,
August 15, 2006;
48(4):
e149 - e246.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Osranek, K. Fatema, F. Qaddoura, A. Al-Saileek, M. E. Barnes, K. R. Bailey, B. J. Gersh, T. S.M. Tsang, K. J. Zehr, and J. B. Seward
Left Atrial Volume Predicts the Risk of Atrial Fibrillation After Cardiac Surgery: A Prospective Study
J. Am. Coll. Cardiol.,
August 15, 2006;
48(4):
779 - 786.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al.
ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society
Circulation,
August 15, 2006;
114(7):
e257 - e354.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. P. Abhayaratna, J. B. Seward, C. P. Appleton, P. S. Douglas, J. K. Oh, A. J. Tajik, and T. S.M. Tsang
Left Atrial Size: Physiologic Determinants and Clinical Applications
J. Am. Coll. Cardiol.,
June 20, 2006;
47(12):
2357 - 2363.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. G. Olsson, K. Swedberg, A. Ducharme, C. B. Granger, E. L. Michelson, J. J.V. McMurray, M. Puu, S. Yusuf, M. A. Pfeffer, and on behalf of the CHARM Investigators
Atrial Fibrillation and Risk of Clinical Events in Chronic Heart Failure With and Without Left Ventricular Systolic Dysfunction: Results From the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) Program
J. Am. Coll. Cardiol.,
May 16, 2006;
47(10):
1997 - 2004.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. S.M. Tsang, W. P. Abhayaratna, M. E. Barnes, Y. Miyasaka, B. J. Gersh, K. R. Bailey, S. S. Cha, and J. B. Seward
Prediction of Cardiovascular Outcomes With Left Atrial Size: Is Volume Superior to Area or Diameter?
J. Am. Coll. Cardiol.,
March 7, 2006;
47(5):
1018 - 1023.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Rienstra and I. C. Van Gelder
Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
Eur. Heart J.,
March 2, 2006;
27(6):
756 - 756.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Lang, M. Bierig, R. B. Devereux, F. A. Flachskampf, E. Foster, P. A. Pellikka, M. H. Picard, M. J. Roman, J. Seward, J. Shanewise, et al.
Recommendations for chamber quantification
Eur J Echocardiogr,
March 1, 2006;
7(2):
79 - 108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Osranek, F. Bursi, K. R. Bailey, B. R. Grossardt, R. D. Brown Jr, S. L. Kopecky, T. S. Tsang, and J. B. Seward
Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
Eur. Heart J.,
December 1, 2005;
26(23):
2556 - 2561.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Reant, S. Lafitte, P. Jais, K. Serri, R. Weerasooriya, M. Hocini, X. Pillois, J. Clementy, M. Haissaguerre, and R. Roudaut
Reverse Remodeling of the Left Cardiac Chambers After Catheter Ablation After 1 Year in a Series of Patients With Isolated Atrial Fibrillation
Circulation,
November 8, 2005;
112(19):
2896 - 2903.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Gersh, T. S.M. Tsang, M. E. Barnes, and J. B. Seward
The changing epidemiology of non-valvular atrial fibrillation: the role of novel risk factors
Eur. Heart J. Suppl.,
May 1, 2005;
7(suppl_C):
C5 - C11.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Woo, W. G. Williams, R. Choi, E. D. Wigle, E. Rozenblyum, K. Fedwick, S. Siu, A. Ralph-Edwards, and H. Rakowski
Clinical and Echocardiographic Determinants of Long-Term Survival After Surgical Myectomy in Obstructive Hypertrophic Cardiomyopathy
Circulation,
April 26, 2005;
111(16):
2033 - 2041.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. I.G.M. Crijns, R. G. Tieleman, I. C. Van Gelder, A. K. Gehi, D. Mehta, L.-F. Hsu, M. Haissaguerre, and P. Jais
Ablation for Atrial Fibrillation in Congestive Heart Failure
N. Engl. J. Med.,
March 17, 2005;
352(11):
1148 - 1149.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Pritchett, D. W. Mahoney, S. J. Jacobsen, R. J. Rodeheffer, B. L. Karon, and M. M. Redfield
Diastolic dysfunction and left atrial volume: A population-based study
J. Am. Coll. Cardiol.,
January 4, 2005;
45(1):
87 - 92.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R. Kizer, B. Dahlof, S. E. Kjeldsen, S. Julius, G. Beevers, U. de Faire, F. Fyhrquist, H. Ibsen, K. Kristianson, O. Lederballe-Pedersen, et al.
Stroke Reduction in Hypertensive Adults With Cardiac Hypertrophy Randomized to Losartan Versus Atenolol: The Losartan Intervention For Endpoint Reduction in Hypertension Study
Hypertension,
January 1, 2005;
45(1):
46 - 52.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Leung, W. H. Bellows, and N. B. Schiller
Impairment of left atrial function predicts post-operative atrial fibrillation after coronary artery bypass graft surgery
Eur. Heart J.,
October 2, 2004;
25(20):
1836 - 1844.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Barnes, Y. Miyasaka, J. B. Seward, B. J. Gersh, A. G. Rosales, K. R. Bailey, G. W. Petty, D. O. Wiebers, and T. S. M. Tsang
Left Atrial Volume in the Prediction of First Ischemic Stroke in an Elderly Cohort Without Atrial Fibrillation
Mayo Clin. Proc.,
August 1, 2004;
79(8):
1008 - 1014.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. Beinart, V. Boyko, E. Schwammenthal, R. Kuperstein, A. Sagie, H. Hod, S. Matetzky, S. Behar, M. Eldar, and M. S. Feinberg
Long-term prognostic significance of left atrial volume in acute myocardial infarction
J. Am. Coll. Cardiol.,
July 21, 2004;
44(2):
327 - 334.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. G. Wyse and B. J. Gersh
Atrial Fibrillation: A Perspective: Thinking Inside and Outside the Box
Circulation,
June 29, 2004;
109(25):
3089 - 3095.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-M. Cha, M. M. Redfield, W.-K. Shen, and B. J. Gersh
Atrial Fibrillation and Ventricular Dysfunction: A Vicious Electromechanical Cycle
Circulation,
June 15, 2004;
109(23):
2839 - 2843.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Hogg, K. Swedberg, and J. McMurray
Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosis
J. Am. Coll. Cardiol.,
February 4, 2004;
43(3):
317 - 327.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. S. M. Tsang, M. E. Barnes, B. J. Gersh, Y. Takemoto, A. G. Rosales, K. R. Bailey, and J. B. Seward
Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography
J. Am. Coll. Cardiol.,
October 1, 2003;
42(7):
1199 - 1205.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. S. M. Tsang, G. W. Petty, M. E. Barnes, W. M. O'Fallon, K. R. Bailey, D. O. Wiebers, J. D. Sicks, T. J. H. Christianson, J. B. Seward, and B. J. Gersh
The prevalence of atrial fibrillation in incident stroke cases and matched population controls in Rochester, Minnesota: Changes over three decades
J. Am. Coll. Cardiol.,
July 2, 2003;
42(1):
93 - 100.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Selvetella, A. Notte, A. Maffei, V. Calistri, V. Scamardella, G. Frati, B. Trimarco, C. Colonnese, and G. Lembo
Left Ventricular Hypertrophy Is Associated With Asymptomatic Cerebral Damage in Hypertensive Patients
Stroke,
July 1, 2003;
34(7):
1766 - 1770.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Pritchett, S. J. Jacobsen, D. W. Mahoney, R. J. Rodeheffer, K. R. Bailey, and M. M. Redfield
Left atrial volume as an index ofleft atrial size: a population-based study
J. Am. Coll. Cardiol.,
March 19, 2003;
41(6):
1036 - 1043.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. N. Singh
Atrial Fibrillation: Epidemiologic Considerations and Rationale for Conversion and Maintenance of Sinus Rhythm
Journal of Cardiovascular Pharmacology and Therapeutics,
March 1, 2003;
8(1_suppl):
S13 - S26.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. H. Opie
Tedisamil in Coronary Disease: Additional Benefits in the Therapy of Atrial Fibrillation?
Journal of Cardiovascular Pharmacology and Therapeutics,
March 1, 2003;
8(1_suppl):
S33 - S37.
[Abstract]
[PDF]
|
|
|
|
|
|
|
I. Savelieva and A. John Camm
Atrial fibrillation and heart failure: natural history and pharmacological treatment
Europace,
January 1, 2003;
5(s1):
S5 - S19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
