Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its
prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD
and AF-related symptom severity has not been well-studied.
In 124 consecutive patients (mean age 61 ± 11years, 60 % male) with paroxysmal (n=70) or
persistent AF (n=54) referred for AF catheter ablation, LVDD was evaluated according to current
guidelines using transthoracic echocardiography. AF-related symptom severity was quantified
using the EHRA score.
LVDD was present in 46 patients (37 %). In uni- and multivariable regression analysis, age (OR
1.068 per year, 95 % CI 1.023 – 1.115, p=.003) and persistent AF (OR 2.427 vs paroxysmal AF,
95 % CI 1.112 – 5.3, p=.026) were associated with LVDD. LVDD was found in 11 % with mild
AF symptoms (n=27) as opposed to 44 % in patients with moderate- severe AF symptoms (n=97,
p=.002). Thus, the OR for moderate-severe AF symptoms was 6.368 (1.797 – 22.568, p=.004) in
the presence of LVDD.
LVDD (1) occurs frequently in AF, (2) is associated with advancing age and AF progression and (3)
is correlated with symptom severity in AF.:1 Introduction ..................................................................................................................................4
1.1 Left ventricular diastolic dysfunction …..........................................................................4
1.1.1 Definition and pathophysiology...........................................................................4
1.1.2 Echocardiographic diagnostic methods ............................................................. 6
1.1.3 Increasing prevalence and importance of left ventricular diastolic dysfunction..9
1.2 Link between left ventricular diastolic dysfunction and atrial fibrillation.....................10
2 Aim of the study .........................................................................................................................12
3 Publication ................................................................................................................................. 12
4 Discussion ..................................................................................................................................18
5 Limitations ................................................................................................................................. 20
6 Conclusion ................................................................................................................................. 20
7 Synopsis ..................................................................................................................................... 21
8 References ..................................................................................................................................22
9 Erklärung ....................................................................................................................................30
10 Curriculum vitae ...................................................................................................................... 31
11 Danksagung ..............................................................................................................................36
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:12818 |
| Date | 22 July 2014 |
| Creators | Kosiuk, Jedrzej |
| Contributors | Bollmann, Andreas, Schuler, Gerhardt, Herzzentrum Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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