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European Heart Journal Advance Access originally published online on February 7, 2006
European Heart Journal 2006 27(6):756; doi:10.1093/eurheartj/ehi770
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up

Michiel Rienstra

Department of Cardiology
Thoraxcenter
University Medical Center Groningen
University of Groningen
The Netherlands

Isabelle C. Van Gelder

Department of Cardiology
Thoraxcenter
University Medical Center Groningen
University of Groningen
PO Box 30.001
9700 RB Groningen
The Netherlands
Tel: +31 50 3612355
Fax: +31 50 3614391
E-mail address: i.c.van.gelder{at}thorax.umcg.nl

We read with great interest the study of Osranek et al.1 on the left atrial volume as a predictor of cardiovascular events in patients originally diagnosed with lone atrial fibrillation (AF). Patients diagnosed with lone AF and normal left atria volume have a benign clinical course, in contrast to patients with increased left atrial volume who developed adverse events, i.e. death, cerebral infarction, myocardial infarction, and congestive heart failure, during the three-decade follow-up. The authors suggest the use of left atrial volume measurement for risk stratification and monitoring of patients with AF. Unfortunately, in this study, diastolic function, as underlying aetiology of AF, was not measured. Although difficult to measure, diastolic dysfunction is known as risk factor for AF,2 and earlier studies have shown that diastolic dysfunction is present in patients diagnosed with lone AF.3 In this study, it remains uncertain, whether the patients with enlarged left atrial volume, indicating elevated left ventricular filling pressures are correctly diagnosed as lone AF. The notion exists that this might represent patients with underlying diastolic dysfunction, rather than lone AF, with a different clinical course.

References

  1. Osranek M, Bursi F, Bailey KR, Grossardt BR, Brown RD Jr, Kopecky SL, Tsang TS, Seward JB. Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up. Eur Heart J 2005;26:2556–2561.[Abstract/Free Full Text]
  2. Tsang TS, Gersh BJ, Appleton CP, Tajik AJ, Barnes ME, Bailey KR, Oh JK, Leibson C, Montgomery SC, Seward JB. Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. J Am Coll Cardiol 2002;40:1636–1644.[Abstract/Free Full Text]
  3. Jais P, Peng JT, Shah DC, Garrigue S, Hocini M, Yamane T, Haissaguerre M, Barold SS, Roudaut R, Clementy J. Left ventricular diastolic dysfunction in patients with so-called lone atrial fibrillation. J Cardiovasc Electrophysiol 2000;11:623–625.[ISI][Medline]

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This Article
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