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: pasqualepalmiero@iciscu.org
The authors thank the nurse,
Mrs. Grazia Quaranta, for her support in management
of patients enrolled in this study.
2008-01-09T00:00:00
Trending Topic
The Ground-BrEAking Electroporation-based inTervention for Atrial Fibrillation (BEAT-AF) treatment project is an initiative funded by the European Commission from the European Union’s Horizon 2020 research and innovation programme, and managed under the European Health and Digital Executive Agency (grant number 945125).1,2 The study was also partly funded by IHU LIRYC ANR-10-IAHU-04. This pioneering 5-year programme commenced on […]
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