Adjusting for the prepreceding RR interval significantly improves the prediction of left ventricular peak ejection velocity in atrial fibrillation, especially when the preceding RR interval is >0.5 seconds and left ventricular function is impaired.
May refine echocardiographic LV assessment in AF; extends RR-interval modeling but remains hypothesis-generating.
In atrial fibrillation, cardiac performance is dependent on both preceding RR (RR-1) and prepreceding RR (RR-2) intervals. However, relative contributions were not well defined. Left ventricular outflow peak ejection velocity (Vpe) was measured by echocardiography from 21 patients. The relation between RR-1 and Vpe could be divided into two zones; steep slope in short RR-1 intervals (< or =0.5 sec) and plateau in long RR-1 intervals (> 0.5 sec). RR-2 had a weak negative association with Vpe. The mean squared correlation coefficient (r2) between RR-2 and Vpe was 0.15 +/-0.13 and improved to 0.29+/-0.21 (p<0.001), when coordinates with RR-1 < or =0.5 sec were excluded. The RR-1 was positively associated with Vpe. The mean r2 between RR-1 and Vpe was 0.52+/-0.17 and improved to 0.72+/-0.11 (p<0.001), when adjusted by RR-2. Simple linear regression analysis showed that mean RR interval, age, fractional shortening (FS), and mean peak velocity were negatively correlated with modified r2 between RR-2 and Vpe. Multiple stepwise regression analysis revealed that mean RR interval (r2=0.32) and FS (r2=0.16) were significant. In summary, simple modification could improve the relationship of both RR-1 and RR-2 with cardiac performance. RR-2 might play a more role in cardiac performance than previously expected, and when cardiac function was impaired.
No takes yet. Share an insight, caveat, or question.
Ko et al. (2002) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: