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Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation

BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. METHODS: A cohort of 154...

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Autores principales: Mishima, Ricardo S., Ariyaratnam, Jonathan P., Pitman, Bradley M., Malik, Varun, Emami, Mehrdad, McNamee, Olivia, Stokes, Michael B., Lau, Dennis H., Sanders, Prashanthan, Elliott, Adrian D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375161/
https://www.ncbi.nlm.nih.gov/pubmed/35971520
http://dx.doi.org/10.1016/j.ijcha.2022.101083
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author Mishima, Ricardo S.
Ariyaratnam, Jonathan P.
Pitman, Bradley M.
Malik, Varun
Emami, Mehrdad
McNamee, Olivia
Stokes, Michael B.
Lau, Dennis H.
Sanders, Prashanthan
Elliott, Adrian D.
author_facet Mishima, Ricardo S.
Ariyaratnam, Jonathan P.
Pitman, Bradley M.
Malik, Varun
Emami, Mehrdad
McNamee, Olivia
Stokes, Michael B.
Lau, Dennis H.
Sanders, Prashanthan
Elliott, Adrian D.
author_sort Mishima, Ricardo S.
collection PubMed
description BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. METHODS: A cohort of 154 consecutive paroxysmal and persistent AF patients (Age: 62 ± 10, 26% female) referred for exercise stress testing and transthoracic echocardiography were included. We included patients in sinus rhythm with preserved left ventricular ejection fraction who were able to complete a maximal exercise test. Left atrial strain in the reservoir (LASr), booster (LASb) and conduit (LASc) phases were assessed using dedicated software. LA stiffness, emptying fraction (LAEF) and LA to LV ratio were calculated using previously described formulas. RESULTS: CRF was positively associated with LAEF (β = 1.3, 95% CI 0.1–2.3, p = 0.02), reservoir (β = 1.5, 95% CI 0.9–2.1, p < 0.001), booster (β = 0.8, 95% CI 0.4–1.2, p < 0.001) and conduit strain (β = 0.7, 95% CI 0.3–1.1, p = 0.001). We observed an inverse association between CRF and both LA stiffness index (β = −0.02, 95% CI (−0.03)–(−0.01), p < 0.001) and LA to LV ratio (β = −0.03, 95% CI (−0.04)–(−0.01), p < 0.001). Obese patients had significantly higher indexed LA volumes compared to overweight and normal BMI patients. The association between obesity and measures of LA function and stiffness did not reach statistical significance. CONCLUSION: Among AF patients, higher CRF was independently associated with greater LA function and compliance. Obesity was associated with higher LA volumes yet preserved mechanical function.
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spelling pubmed-93751612022-08-14 Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation Mishima, Ricardo S. Ariyaratnam, Jonathan P. Pitman, Bradley M. Malik, Varun Emami, Mehrdad McNamee, Olivia Stokes, Michael B. Lau, Dennis H. Sanders, Prashanthan Elliott, Adrian D. Int J Cardiol Heart Vasc Original Paper BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are related to the development and maintenance of atrial fibrillation (AF). The aim of this study was to determine the association between CRF, obesity and left atrial (LA) mechanical parameters in patients with AF. METHODS: A cohort of 154 consecutive paroxysmal and persistent AF patients (Age: 62 ± 10, 26% female) referred for exercise stress testing and transthoracic echocardiography were included. We included patients in sinus rhythm with preserved left ventricular ejection fraction who were able to complete a maximal exercise test. Left atrial strain in the reservoir (LASr), booster (LASb) and conduit (LASc) phases were assessed using dedicated software. LA stiffness, emptying fraction (LAEF) and LA to LV ratio were calculated using previously described formulas. RESULTS: CRF was positively associated with LAEF (β = 1.3, 95% CI 0.1–2.3, p = 0.02), reservoir (β = 1.5, 95% CI 0.9–2.1, p < 0.001), booster (β = 0.8, 95% CI 0.4–1.2, p < 0.001) and conduit strain (β = 0.7, 95% CI 0.3–1.1, p = 0.001). We observed an inverse association between CRF and both LA stiffness index (β = −0.02, 95% CI (−0.03)–(−0.01), p < 0.001) and LA to LV ratio (β = −0.03, 95% CI (−0.04)–(−0.01), p < 0.001). Obese patients had significantly higher indexed LA volumes compared to overweight and normal BMI patients. The association between obesity and measures of LA function and stiffness did not reach statistical significance. CONCLUSION: Among AF patients, higher CRF was independently associated with greater LA function and compliance. Obesity was associated with higher LA volumes yet preserved mechanical function. Elsevier 2022-08-06 /pmc/articles/PMC9375161/ /pubmed/35971520 http://dx.doi.org/10.1016/j.ijcha.2022.101083 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Mishima, Ricardo S.
Ariyaratnam, Jonathan P.
Pitman, Bradley M.
Malik, Varun
Emami, Mehrdad
McNamee, Olivia
Stokes, Michael B.
Lau, Dennis H.
Sanders, Prashanthan
Elliott, Adrian D.
Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title_full Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title_fullStr Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title_full_unstemmed Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title_short Cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
title_sort cardiorespiratory fitness, obesity and left atrial function in patients with atrial fibrillation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375161/
https://www.ncbi.nlm.nih.gov/pubmed/35971520
http://dx.doi.org/10.1016/j.ijcha.2022.101083
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