Left ventricular diastolic dysfunction and increased left atrial volume predict arrhythmia recurrence in patients with atrial fibrillation.

摘要

We have read with great interest the recently published article by Psychari and coworkers in which they investigated the plasma levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and N-terminal pro-brain natriuretic peptide (NTpro-BNP) in atrial fibrillation (AF) immediately post cardioversion and at 1 month. They reported that the plasma levels of hs-CRP, IL-6, and NTpro-BNP were not correlated with AF recurrence rates. Only in lone AF subgroup which included 26 participants, the plasma levels of NTpro-BNP differed significantly from non-lone AF subgroup during follow-up. The strongest predictor of AF recurrence was left atrial volume indexed for body surface area which was highly correlated with plasma NTpro-BNP levels. Unfortunately, the echocardiographic parameters of left ventricular (LV) diastolic function and correlation of these parameters with atrial volumes were not reported in their article. Presence of LV diastolic dysfunction may predispose to AF. Concerning the high frequency of participants with hypertension in their study population, analysis of the correlation between LV diastolic dysfunction and AF recurrence rates could have helped to elucidate this issue.