Key result
Prolonged PA-TDI duration was independently associated with new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy (HR 1.03; 95% CI 1.01-1.05; P<0.001).
Why the study?
AF is common in HCM and linked to poor outcomes, and whether total atrial conduction time estimated by TDI (PA-TDI duration) associates with new-onset AF required evaluation.
Does prolonged PA-TDI duration predict new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy?
Cohort (n=208)
Does prolonged PA-TDI duration predict new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy?
Effect estimate: HR 1.03 (95% CI 1.01-1.05)
p-value: p=<0.001
Prolonged PA-TDI duration measured by tissue Doppler imaging is an independent predictor of new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy.
PA-TDI may refine AF risk assessment in HCM; hypothesis-generating pending prospective validation.
AIMS: Atrial fibrillation (AF) is frequently observed in hypertrophic cardiomyopathy (HCM) and is associated with poor clinical outcome. Total atrial conduction time, estimated by tissue Doppler imaging (TDI), the so-called PA-TDI duration, reflects the left atrial (LA) structural and electrical remodelling. The aim of this study was to evaluate the association between PA-TDI and new-onset AF in patients with HCM. METHODS AND RESULTS: From a large cohort of patients with HCM, 208 patients (64% male, mean age 53 ± 14 years) without AF were selected. PA-TDI duration was measured from the onset P wave on electrocardiogram to the peak A' wave of the lateral LA wall using TDI. The incidence of new-onset AF was 20% over a median follow-up of 7.3 (3.5-10.5) years. Patients with incident AF had longer PA-TDI duration when compared with patients without AF (133.7 ± 23.0 vs. 110.5 ± 30.0 ms, P < 0.001). PA-TDI duration was independently associated with new-onset AF (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, P < 0.001). CONCLUSION: Prolonged PA-TDI duration was independently associated with new-onset AF in patients with HCM. This novel parameter could be useful to risk-stratify patients with HCM who are at risk of having AF.
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Tjahjadi et al. (2020) conducted a cohort in Hypertrophic cardiomyopathy (n=208). PA-TDI duration was evaluated on new-onset atrial fibrillation (HR 1.03, 95% CI 1.01-1.05, p=<0.001). Prolonged PA-TDI duration was independently associated with new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy (HR 1.03; 95% CI 1.01-1.05; P<0.001).
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