Journal List > Korean Circ J > v.38(10) > 1016389

Choi, Kim, Cho, Kim, Seo, Lee, Lee, Kim, Kim, Ko, Kim, and Ryu: Relationship Between RR Intervals and Early Diastolic Mitral Annulus Velocities in Atrial Fibrillation Patients Who do not Have Significant Valvular Diseases

Abstract

Background and Objectives

Irregular RR intervals in atrial fibrillation (AF) results in beat to beat changes in hemodynamical parameters. Early diastolic mitral annulus velocity (E') is one of the parameters that represent diastolic function of the left ventricle (LV). In this study, we have investigated the effects of continuous changes of systolic functions in AF on the diastolic functions of the LV.

Subjects and Methods

E' (35-40 beats) was recorded in 31 AF patients that did not have significant valvular heart diseases. The relationships between preceding RR intervals (RR-1) or pre-preceding RR intervals (RR-2) and E's were obtained using a logarithmic function.

Results

Slopes between RR-1 and E' varied from -1.62 to 1.04 in total coordinates. In the logistic regression analysis patients with negative slopes were found to have a larger left atrial size than patients with positive slopes (5.5±0.67 cm vs. 4.9±0.56 cm, p=0.02). Slopes were negatively related with mean RR intervals in the Pearson correlation analysis (r=-0.40, p=0.028). Slopes between RR-2 and E' were also variable and were not associated with other parameters.

Conclusion

Beat to beat changes in systolic functions derived from irregular RR intervals in AF had variable effects on diastolic functions among patients. The relationship between RR-1 and E' was associated with LA sizes and mean RR intervals.

Figures and Tables

Fig. 1
Representative examples of negative (A) and positive (B) relationships between preceding RR intervals and early diastolic mitral annulus velocities.
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Fig. 2
Relationship of slopes between preceding RR intervals and early diastolic mitral annulus velocities with mean RR intervals (A) and left atrial (LA) sizes (B).
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Table 1
Clinical characteristics of patients
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LVIDd/LVIDs: left ventricular internal dimension diastolic/systolic, IVSd/LVPWd: diastolic thickness of interventricular septum/diastolic thickness of left ventricular posterior wall, AT: acceleration time, DT: deceleration time, ACE: angiotensin converting enzyme

Table 2
Comparisons between patients with negative and positive relationships between RR intervals and early diastolic mitral annulus velocities
kcj-38-551-i002

LVIDd: diastolic dimension of left ventricle, LVIDs: systolic dimension of left ventricle, FS: fractional shortening, IVS: diastolic thickness of interventricular septum, LVPW: diastolic thickness of left ventricular posterior wall, LA: left atrium, E: early diastolic mitral flow velocity, DT: deceleration time, E': early diastolic mitral annulus velocity

Table 3
Relationship of the slope derived from the correlation between RR intervals and early diastolic mitral annulus velocities with clinical and echocardiographic variables
kcj-38-551-i003

RR-1: preceding RR interval, RR-2: pre-preceding RR interval, LVIDd: diastolic dimension of left ventricle, LVIDs: systolic dimension of left ventricle, FS: fractional shortening, IVS: diastolic thickness of interventricular septum, LVPW: diastolic thickness of left ventricular posterior wall, LA: left atrium, DT: deceleration time

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