The Korean journal of internal medicine

  • 제30권6호
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  • Pages.808-820
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  • 2015
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation

  • Lim, Hong Euy (Cardiovascular Center, Korea University Guro Hospital) ;
  • Na, Jin Oh (Cardiovascular Center, Korea University Guro Hospital) ;
  • Im, Sung Il (Cardiovascular Center, Korea University Guro Hospital) ;
  • Choi, Cheol Ung (Cardiovascular Center, Korea University Guro Hospital) ;
  • Kim, Seong Hwan (Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Kim, Jin Won (Cardiovascular Center, Korea University Guro Hospital) ;
  • Kim, Eung Ju (Cardiovascular Center, Korea University Guro Hospital) ;
  • Han, Seong Woo (Division of Cardiology, Department of Internal Medicine, Hallym University Hangang Sacred Heart Hospital) ;
  • Rha, Seung-Woon (Cardiovascular Center, Korea University Guro Hospital) ;
  • Park, Chang Gyu (Cardiovascular Center, Korea University Guro Hospital) ;
  • Seo, Hong Seog (Cardiovascular Center, Korea University Guro Hospital) ;
  • Oh, Dong Joo (Cardiovascular Center, Korea University Guro Hospital) ;
  • Hwang, Chun (Division of Cardiology, Utah Valley Regional Medical Center)
  • 투고 : 2014.05.12
  • 심사 : 2014.09.23
  • 발행 : 2015.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. Methods: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage ($LA_{VOL}$) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. Results: IAS thickness was significantly correlated with maximal LAV ($LAV_{max}$) (r = 0.288, p = 0.003), mean $LA_{VOL}$ (r = -0.537, p < 0.001), total left atrium emptying fraction ($LAEF_{total}$; r = -0.213, p = 0.030), and active LAEF ($LAEF_{active}$; r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (${\geq}2$) compared to other groups according to $CHA_2DS_2$-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that $LAV_{max}$, minimal LAV, mean $LA_{VOL}$, $LVEF_{total}$, $LVEF_{active}$, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean $LA_{VOL}$ and $LAEF_{active}$ were independent risk factors for recurrence. Conclusions: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.

키워드

과제정보

연구 과제 주관 기관 : Korea University Medical Center

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