Left ventricular-to-right atrial shunt (LVRAS) was independently associated with a significantly higher risk of atrial fibrillation (OR 12.217) compared to patients without LVRAS.
Observational (n=3,436)
No
Does left ventricular-to-right atrial shunt increase the incidence of atrial fibrillation in patients undergoing echocardiography?
Left ventricular-to-right atrial shunt is a significant independent risk factor for atrial fibrillation, likely mediated by right atrial enlargement.
Estimación del efecto: OR 12.217 (95% CI 2.434-61.334)
Tasa de eventos absoluta: 77.5% vs 13.3%
valor p: p=<0.001
Background: The possible association between atrial fibrillation (AF) and left ventricular-to-right atrial shunt (LVRAS) has never been reported yet. The present study investigated the incidence of AF in LVRAS. Methods: This was a retrospective study of consecutive patients undergoing echocardiography at a single tertiary center. Clinical data, laboratory results and echocardiography parameters such as right atrial area (RAA), right ventricular end diastolic diameter (RVDD) and left atrial diameter (LAD) were compared between LVRAS group and non-LVRAS patients, and between AF and non-AF patients. Propensity score matching was performed to decrease the effect of confounders. Logistic regression analysis and mediation analysis were used to estimate the relationship between LVRAS and AF. Results: A total of 3,436 patients were included, and the incidence of LVRAS was 1.16% ( n = 40). The LVRAS group had significantly larger RAA, RVDD and LAD compared with non-LVRAS group. Those who suffered from AF showed larger RAA, RVDD and LAD compared with those who maintained sinus rhythm. Multivariable logistic regression showed that gender (OR: 0.608), age (OR: 1.048), LAD (OR: 1.111), mean pulmonary artery blood pressure (mPAP, OR: 1.023), TR (OR: 2.309) and LVRAS (OR: 12.217) were significant factors for AF. RAA could partially mediate the relationship between LVRAS and AF according to the result of mediation analysis. Conclusions: Our study suggested that LVRAS, TR, LAD, mPAP, age and male were risk factors for AF. RA enlargement might underlie mechanism in the higher incidence of AF in LVRAS patients. These findings should be confirmed in larger prospective studies.
Chou et al. (Mon,) conducted a observational in Left ventricular-to-right atrial shunt (LVRAS) and Atrial Fibrillation (n=3,436). Left ventricular-to-right atrial shunt (LVRAS) vs. Non-LVRAS was evaluated on Incidence of atrial fibrillation (OR 12.217, 95% CI 2.434-61.334, p=<0.001). Left ventricular-to-right atrial shunt (LVRAS) was independently associated with a significantly higher risk of atrial fibrillation (OR 12.217) compared to patients without LVRAS.