• Ione Limantoro, Cees B de Vos, Tammo Delhaas, Bob Weijs, Yuri Blaauw, Ulrich Schotten, Bas Kietselaer, Ron Pisters, and Harry J G M Crijns.
• Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, Maastricht 6202 AZ, The Netherlands ione.limantoro@gmail.com.
• Europace. 2014 Nov 1; 16 (11): 1546-53.

AimsIn patients with atrial fibrillation (AF), echocardiographic tissue velocity imaging (TVI) enables assessment of electrical and structural remodelling by measuring, respectively, the AF cycle length (AFCL-TVI) and the atrial fibrillatory wall motion velocity (AFV-TVI). We investigated the clinical and echocardiographic correlates of atrial remodelling assessed by TVI.Methods And ResultsWe studied 215 patients presenting with AF. In all patients, we measured the AFCL-TVI and the AFV-TVI in the left atrium. Standard baseline characteristics were recorded. We divided patients by median value of AFV-TVI and AFCL-TVI to evaluate the determinants of atrial remodelling. A low AFV-TVI was related with a longer median duration of the current AF episode, a higher prevalence of significant mitral regurgitation and a thicker left ventricle (LV). Multivariate analysis revealed that a low AFV-TVI was independently associated with a longer median duration of the current AF episode [OR 0.09 (95% CI 0.03-0.027); P < 0.001]. Univariately, a short AFCL-TVI was associated with a long median duration of the current AF episode, the use of anti-arrhythmic drugs, a lower LV ejection fraction (LVEF) and a smaller left atrial volume index (LAVI). Multivariate analysis revealed that LVEF [OR 1.48 (95% CI 1.09-2.01); P = 0.013] and LAVI [OR 1.37 (95% CI 1.08-1.74); P = 0.010] were independently associated with AFCL-TVI.ConclusionThis study investigated the clinical and echocardiographic correlates of atrial remodelling assessed by TVI. The AFV-TVI is reduced in patients with a long AF duration and who have mitral regurgitation. In addition, the AFCL is long if LAVI is high and LVEF preserved. Tissue velocity imaging parameters measured during AF may be helpful to characterize the degree of atrial remodelling and optimize treatment.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

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