Abstract 15928: Decreased Left Ventricular Compliance is Associated With Worsened Symptoms of Atrial Fibrillation
Introduction: The factors and comorbities related to worsening symptomatology in patients with atrial fibrillation (AF) are not fully understood.Hypothesis:Patients with decreased left ventricular (LV) compliance as indicated by increased LV mass and left atrial (LA) volume may have worsening symptoms while in AF.
Methods: Eighty-eight patients evaluated in the electrophysiology clinic completed questionnaires including the University of Toronto AF Symptom and Severity Checklist (AFSS, score of 0-35) and underwent a screening transthoracic echocardiogram. As per the American Society of Echocardiography guidelines, standard structural, systolic function, and diastolic function measurements were obtained. Both chamber volumes and LV mass were indexed to body surface area. Multivariable linear regression was used to assess the predictors of symptomatic AF.
Results: Among the cohort, mean age was 61.3 ± 14.5 years, 65.9% were male, 87.8% were Caucasian, and 53.7% had persistent AF. Co-morbidities included hypertension (59.8%), diabetes (19.5%), previous myocardial infarction (17.1%), and smoking (6.1%). Mean LV mass was 85.3 ± 23.9 g/m2, mean LA volume was 36.1 ± 14.5 ml/m2. Mean AFSS score was 14.3 ± 8.3. After adjusting for age, gender, persistent vs paroxysmal AF, HTN, previous MI, DM, and smoking, AFSS score was independently associated with increased LV mass index (0.12 increased AFSS score per g/m2, p=.006; Fig) and LA volume index (0.19 increased AFSS score per ml/m2, p=.003).
Conclusion: Patients with decreased LV compliance, indicated by LA enlargement and LV hypertophy, have worsened symptoms with AF. Patients with decreased LV compliance may derive a greater absolute benefit from rhythm controlling strategies.
- © 2011 by American Heart Association, Inc.