Persistent non-valvular atrial fibrillation (NVAF) is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives from populations enrolled in randomized clinical trials. However, participants in clinical trials are often not representative of the general population. Many stroke risk stratification scores have been used, but they do not include transthoracic echocardiogram (TTE), pulsate wave Doppler (PWD) and tissue Doppler imaging (TDI), simple and non- invasive diagnostic tools. The role of TTE, PWD and TDI findings has not been previously determined. Our study goal was to determine the association between TTE and PWD findings and stroke prevalence in a population of NVAF prone outpatients. Patients were divided into two groups: P for stroke prone and F for stroke free. There were no statistically significant differences between the two groups concerning cardiovascular risk factors, age (p=0.2), sex (p=0.2), smoking (p=0.3), diabetes (p=0.1) and hypercholesterolemia (p=0.2); hypertension was statistically significant (p<0.001). There were statistically significant differences concerning coronary artery disease, previous acute myocardial infarction (AMI) (p<0.05) and non- AMI coronaropathy (p<0.04), a higher rate being in the P group. Concerning echo-Doppler findings, a higher statistically significant rate of left ventricular hypertrophy (LVH) (p<0.05) and left ventricular diastolic dysfunction (p<0.001) was found in the P group and dilated left atrium (p<0.04) in the F group, the difference was not significant for mitral regurgitation (p=0.7). Stroke prone NVAF patients have a higher rate of hypertension, coronary artery disease, with and without AMI, LVH and left ventricular diastolic dysfunction, but not left atrial dilatation. M-B mode echocardiography and PWD examination help to identify highrisk stroke patients among NVAF subjects; therefore, they may help in the selection of appropriate therapy for each patient.
Atrial fibrillation, stroke, hypertension, coronary artery disease, left ventricular hypertrophy, left atrial dilatation, echocardiography.
Pasquale Palmiero, Via Francia 47, 72100 Brindisi, Italy E-mail: firstname.lastname@example.org
The authors thank the nurse,
Mrs. Grazia Quaranta, for her support in management
of patients enrolled in this study.
Share this Article
Related Content In Atrial Fibrillation
Globe Pulsed Field System for High-definition Mapping and Ablation for Atrial Fibrillation
Heart International. 2022;16(2):85–90 DOI: https://doi.org/10.17925/HI.2022.16.2.85
Catheter ablation has emerged as an effective strategy for the treatment of atrial fibrillation (AF), even becoming a first-line option for selected patients.1 Pulmonary vein isolation (PVI) is the cornerstone of this procedure. Ablation beyond PVI is often practised, but scientific evidence from randomized clinical trials is still controversial.2–8 Point-by-point radiofrequency (RF) ablation has been, by […]
Should Catheter Ablation for Atrial Fibrillation be a Priority in Patients with Heart Failure with Reduced Ejection Fraction?
European Journal of Arrhythmia & Electrophysiology. 2022;8(1):20-4 DOI: https://doi.org/10.17925/EJAE.2022.8.1.20
Heart failure (HF) and atrial fibrillation (AF) are inexorably linked. They frequently coexist and share common risk factors, including ageing, hypertension, diabetes, obesity, sleep apnoea and coronary disease.1–4 Over half of patients with HF develop AF at some point,5 and when AF occurs, it is associated with an increase in total mortality of up to 40%.6 In addition, […]
Foreword – European Journal of Arrhythmia & Electrophysiology, Volume 8, Issue 1, 2022
Welcome to the latest edition of European Journal of Arrhythmia & Electrophysiology. Cardiac arrhythmias, the most common of which is atrial fibrillation, represent a substantial health and economic burden worldwide. In the last two decades we have observed major breakthroughs in the management of arrhythmias, particularly in the field of cardiac electrophysiology, and some of the […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!