Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
Eur Heart J Cardiovasc Imaging. 2021 Apr 28;22(5):589-596. doi: 10.1093/ehjci/jeaa174.
Atrial fibrillation (AF) is frequently observed in hypertrophic cardiomyopathy (HCM) and is associated with poor clinical outcome. Total atrial conduction time, estimated by tissue Doppler imaging (TDI), the so-called PA-TDI duration, reflects the left atrial (LA) structural and electrical remodelling. The aim of this study was to evaluate the association between PA-TDI and new-onset AF in patients with HCM.
From a large cohort of patients with HCM, 208 patients (64% male, mean age 53 ± 14 years) without AF were selected. PA-TDI duration was measured from the onset P wave on electrocardiogram to the peak A' wave of the lateral LA wall using TDI. The incidence of new-onset AF was 20% over a median follow-up of 7.3 (3.5-10.5) years. Patients with incident AF had longer PA-TDI duration when compared with patients without AF (133.7 ± 23.0 vs. 110.5 ± 30.0 ms, P < 0.001). PA-TDI duration was independently associated with new-onset AF (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, P < 0.001).
Prolonged PA-TDI duration was independently associated with new-onset AF in patients with HCM. This novel parameter could be useful to risk-stratify patients with HCM who are at risk of having AF.
心房颤动（AF）在肥厚型心肌病（HCM）中经常发生，并与不良临床结局相关。组织多普勒成像（TDI）估计的总心房传导时间，即所谓的 PA-TDI 持续时间，反映了左心房（LA）的结构和电重构。本研究旨在评估 HCM 患者的 PA-TDI 与新发 AF 之间的关系。
从一个大型 HCM 患者队列中，选择了 208 名（64%为男性，平均年龄 53±14 岁）无 AF 的患者。使用 TDI 从心电图上 P 波起始到 LA 侧壁 A'波峰值测量 PA-TDI 持续时间。在中位数为 7.3（3.5-10.5）年的随访期间，新发 AF 的发生率为 20%。与无新发 AF 的患者相比，新发 AF 患者的 PA-TDI 持续时间更长（133.7±23.0 比 110.5±30.0 ms，P<0.001）。PA-TDI 持续时间与新发 AF 独立相关（风险比：1.03，95%置信区间：1.01-1.05，P<0.001）。
在 HCM 患者中，PA-TDI 持续时间延长与新发 AF 独立相关。这个新的参数可能有助于对有发生 AF 风险的 HCM 患者进行风险分层。
