The impact of atrial fibrillation and stroke risk factors on left atrial blood flow characteristics.

Spartera M., Stracquadanio A., Pessoa-Amorim G., Von Ende A., Fletcher A., Manley P., Ferreira VM., Hess AT., Hopewell JC., Neubauer S., Wijesurendra RS., Casadei B.

AIMS: Altered left atrial (LA) blood flow characteristics account for an increase in cardioembolic stroke risk in atrial fibrillation (AF). Here, we aimed to assess whether exposure to stroke risk factors is sufficient to alter LA blood flow even in the presence of sinus rhythm (SR). METHODS AND RESULTS: We investigated 95 individuals: 37 patients with persistent AF, who were studied before and after cardioversion [Group 1; median CHA2DS2-VASc = 2.0 (1.5-3.5)]; 35 individuals with no history of AF but similar stroke risk to Group 1 [Group 2; median CHA2DS2-VASc = 3.0 (2.0-4.0)]; and 23 low-risk individuals in SR [Group 3; median CHA2DS2-VASc = 0.0 (0.0-0.0)]. Cardiac function and LA flow characteristics were evaluated using cardiac magnetic resonance. Before cardioversion, Group 1 displayed impaired left ventricular (LV) and LA function, reduced LA flow velocities and vorticity, and a higher normalized vortex volume (all P 

DOI

10.1093/ehjci/jeab213

Type

Journal article

Journal

Eur Heart J Cardiovasc Imaging

Publication Date

18/12/2021

Volume

23

Pages

115 - 123

Keywords

4D flow CMR, atrial fibrillation, cardioversion, left atrial myopathy, stroke risk, Atrial Appendage, Atrial Fibrillation, Atrial Function, Left, Humans, Risk Factors, Stroke

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