Mirror image atrial dilatation in adult patients with atrial fibrillation and congenital heart disease.

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State: Public
Version: author
Serval ID
serval:BIB_4956E0014D5A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mirror image atrial dilatation in adult patients with atrial fibrillation and congenital heart disease.
Journal
International Journal of Cardiology
Author(s)
Bouchardy J., Marelli A.J., Martucci G., Bottega N., Therrien J.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
2013
Volume
167
Number
3
Pages
816-820
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
BACKGROUND: Atrial fibrillation (AF) is largely regarded to be initiated from left atrial (LA) dilatation, with subsequent dilatation of the right atrium (RA) in those who progress to chronic AF. We hypothesized that in adult patients with right-sided congenital heart disease (CHD) and AF, RA dilatation will predominate with subsequent dilatation of the left atrium, as a mirror image.
METHODS: Adult patients with diagnosis of right-sided, ASD or left-sided CHD who had undergone an echocardiographic study and electrocardiographic recording in 2007 were included. RA and LA area were measured from the apical view. AF was diagnosed from a 12-lead electrocardiogram or Holter recording. A multivariate logistic regression model was used to identify predictors of AF and linear regression models were performed to measure relationship between RA and LA area and AF.
RESULTS: A total of 291 patients were included in the study. Multivariate analysis showed that age (p=0.0001), RA (p=0.025) and LA area (p=0.0016) were significantly related to AF. In patients with pure left-sided pathologies, there was progressive and predominant LA dilatation that paralleled the development of AF from none to paroxysmal to chronic AF. In patients with pure right-sided pathologies, there was a mirror image of progressive and predominant RA dilatation with the development of AF.
CONCLUSION: We observed a mirror image atrial dilatation in patients with right sided disease and AF. This may provide novel mechanistic insight as to the origin of AF in these patients and deserves further studying in the form of targeted electrophysiological studies.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Atrial Fibrillation/physiopathology, Atrial Fibrillation/ultrasonography, Databases, Factual, Dilatation, Pathologic/physiopathology, Dilatation, Pathologic/ultrasonography, Female, Heart Atria/physiopathology, Heart Atria/ultrasonography, Heart Defects, Congenital/physiopathology, Heart Defects, Congenital/ultrasonography, Humans, Male, Middle Aged, Young Adult
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Web of science
Create date
05/06/2014 16:02
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20/08/2019 14:56
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