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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Cardiovascular Ultrasound 1/2012

Left atrial pathological degeneration assessed by integrated backscatter transesophageal echocardiography as a predictor of progression to persistent atrial fibrillation: Results from a prospective study of three-years follow-up

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2012
Autoren:
Tomoki Kubota, Masanori Kawasaki, Nobuhiro Takasugi, Hajime Imai, Yoshiyuki Ishihara, Munenori Okubo, Shigekiyo Takahashi, Hironobu Sato, Kazuhiko Nishigaki, Genzou Takemura, Shinya Minatoguchi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-10-28) contains supplementary material, which is available to authorized users.

Authors’ contributions

TK and NT carried out subject recruitment and analyzed data. MK analyzed data and wrote the manuscript. HI, YI, MO, ST and HS performed integrated backscatter ultrasound analysis. KN, GT and SM analyzed data. All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Abstract

Background

It is recognized that one of the causes of atrial fibrillation (AF) is pathological degeneration of the left atrium (LA). However, prospective study that elucidated the relationship between the incidence of persistent AF and pathological degeneration has not been performed. The purpose of this study was to elucidate the usefulness of integrated backscatter (IBS) values for the prediction of progression from paroxysmal AF (PAF) to persistent AF.

Methods

We measured IBS values of the entire LA wall at 5 mm intervals (except the posterior wall) in 27 patients with paroxysmal AF and evaluated progression to persistent AF for three years. IBS values were acquired with transesophageal echocardiography (TEE) using a 4–7 MHz transducer. IBS values were calculated as the average power of the backscattered signal from regions of interest (ROI). Each IBS value was color-coded to construct three dimensional maps.

Results

Average IBS values of total voxels in color-coded maps in the persistent AF group were significantly greater than those in the non-persistent AF group (25.8 ± 5.0 dB vs. 17.4 ± 10.2 dB, p = 0.047), whereas there was no significant difference in LA diameter between the persistent AF and the non-persistent AF group. There was significant difference in persistent AF-free survival after the baseline measurements in the subjects stratified by IBS value (<20 dB versus ≥20 dB) (univariate Cox regression analysis: hazard ratio: 8.74, p =0.046).

Conclusion

Using IBS values measured by TEE, we can identify an increase in atrial degeneration that may predict the occurrence of persistent AF before LA dilation.
Zusatzmaterial
Authors’ original file for figure 1
12947_2012_424_MOESM1_ESM.pdf
Authors’ original file for figure 2
12947_2012_424_MOESM2_ESM.pdf
Authors’ original file for figure 3
12947_2012_424_MOESM3_ESM.pdf
Authors’ original file for figure 4
12947_2012_424_MOESM4_ESM.pdf
Literatur
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