Left ventricular diastolic dysfunction in atrial fibrillation: predictors and relation with symptom severity

J Cardiovasc Electrophysiol. 2012 Oct;23(10):1073-7. doi: 10.1111/j.1540-8167.2012.02368.x. Epub 2012 Jun 5.

Abstract

Background: Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD and AF-related symptom severity has not been well studied.

Methods: In 124 consecutive patients (mean age 61 ± 11years, 60% male) with paroxysmal (n = 70) or persistent AF (n = 54) referred for AF catheter ablation, LVDD was evaluated according to current guidelines using transthoracic echocardiography. AF-related symptom severity was quantified using the European Heart Rhythm Association score.

Results: LVDD was present in 46 patients (37%). In uni- and multivariable regression analysis, age (OR 1.068 per year, 95% CI 1.023-1.115, P = 0.003) and persistent AF (OR 2.427 vs. paroxysmal AF, 95% CI 1.112-5.3, P = 0.026) were associated with LVDD. LVDD was found in 11% with mild AF symptoms (n = 27) as opposed to 44% in patients with moderate-severe AF symptoms (n = 97, P = 0.002). Thus, the OR for moderate-severe AF symptoms was 6.368 (1.797-22.568, P = 0.004) in the presence of LVDD.

Conclusions: LVDD (1) occurs frequently in AF, (2) is associated with advancing age and AF progression and (3) is correlated with symptom severity in AF.

MeSH terms

  • Age Factors
  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery
  • Catheter Ablation
  • Chi-Square Distribution
  • Disease Progression
  • Echocardiography, Doppler
  • Electrocardiography, Ambulatory
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*