Moderate-to-high stroke risk factors were associated with lower left atrial flow peak and mean velocity, and vorticity in sinus rhythm compared to low-risk individuals (P<0.01).
Observational (n=95)
Do stroke risk factors alter left atrial blood flow characteristics even in the presence of sinus rhythm?
Moderate-to-high stroke risk factors are sufficient to alter left atrial blood flow characteristics and cause an LA myopathic phenotype even in sinus rhythm, independent of atrial fibrillation history.
p-value: p=<0.01
AIMS: Altered left atrial (LA) blood flow characteristics account for an increase in cardioembolic stroke risk in atrial fibrillation (AF). Here, we aimed to assess whether exposure to stroke risk factors is sufficient to alter LA blood flow even in the presence of sinus rhythm (SR). METHODS AND RESULTS: We investigated 95 individuals: 37 patients with persistent AF, who were studied before and after cardioversion Group 1; median CHA2DS2-VASc = 2.0 (1.5-3.5); 35 individuals with no history of AF but similar stroke risk to Group 1 Group 2; median CHA2DS2-VASc = 3.0 (2.0-4.0); and 23 low-risk individuals in SR Group 3; median CHA2DS2-VASc = 0.0 (0.0-0.0). Cardiac function and LA flow characteristics were evaluated using cardiac magnetic resonance. Before cardioversion, Group 1 displayed impaired left ventricular (LV) and LA function, reduced LA flow velocities and vorticity, and a higher normalized vortex volume (all P < 0.001 vs. Groups 2 and 3). After restoration of SR at ≥4-week post-cardioversion, LV systolic function and LA flow parameters improved significantly (all P < 0.001 vs. pre-cardioversion) and were no longer different from those in Group 2. However, in the presence of SR, LA flow peak and mean velocity, and vorticity were lower in Groups 1 and 2 vs. Group 3 (all P < 0.01), and were associated with impaired LA emptying fraction (LAEF) and LV diastolic dysfunction. CONCLUSION: Patients at moderate-to-high stroke risk display altered LA flow characteristics in SR in association with an LA myopathic phenotype and LV diastolic dysfunction, regardless of a history of AF.
Spartera et al. (Thu,) conducted a observational in Atrial fibrillation and stroke risk factors (n=95). Moderate-to-high stroke risk factors vs. Low stroke risk was evaluated on Left atrial flow peak and mean velocity, and vorticity (p=<0.01). Moderate-to-high stroke risk factors were associated with lower left atrial flow peak and mean velocity, and vorticity in sinus rhythm compared to low-risk individuals (P<0.01).