Key result
Higher E/e' ratio is linked to increased left atrial hypertension during incremental pacing.
Why the study?
Left atrial hypertension is a key pathophysiology in HFpEF, and the relationship between atrial pacing-induced left atrial pressure response and diastolic dysfunction needed clarification.
Observational (n=238)
Effect estimate: r=0.373
p-value: p=<0.001
E/e' may flag risk of pacing-induced left atrial hypertension independent of AF; leaves open its role in guiding HFpEF evaluation.
Introduction: Left atrial hypertension is one of the pathophysiologies of heart failure with preserved ejection fraction. We hypothesized that left atrial pressure response (LAPR) to incremental pacing is higher in patients with atrial fibrillation (AF) and can predict left ventricular diastolic dysfunction. Methods: Patients requiring left atrial access as a part of a therapeutic procedure for AF (n=204, AF group) or supraventricular tachycardia (n=34, control group) were analyzed (male n=183, 54±12 years old). LAPR was measured during incremental pacing. Results: Baseline left atrial pressure and LAPR at all pacing rates were not different between the AF and control groups. They were higher in patients with a high E/e’ (≥ 8) than in those with a low E/e’ (< 8). LAPR at a pacing interval of 400ms and E/e' were positively correlated (r=0.373, p<0.001). Body mass index and a high E/e' were independent predictors of pacing-induced left atrial hypertension. Conclusions: The LAPR to incremental pacing was constant regardless of AF. The non-invasive echocardiographic marker E/e' reflected pacing-induced left atrial hypertension.
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Roh et al. (2021) conducted an observational in Atrial fibrillation and supraventricular tachycardia (n=238). High E/e' ratio (≥ 8) vs. Low E/e' ratio (< 8) was evaluated on Left atrial pressure response (LAPR) to incremental pacing (r=0.373, p=<0.001). A high E/e' ratio (≥ 8) was an independent predictor of pacing-induced left atrial hypertension, with E/e' positively correlating with left atrial pressure response (r=0.373, p<0.001).
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