E/E′ Is a New Independent Predictor of Recovered Ejection Fraction in Patients With Systolic Heart Failure Undergoing Ablation for Atrial Fibrillation

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Yuanjun Sun¹  Guocao Li¹  Yiheng Yang¹  Rongfeng Zhang¹  Xiaohong Yu¹  Minghui Yang¹  Huamin Tang¹  Lianjun Gao¹  Xumin Guan¹  Xianjie Xiao¹  Xiaomeng Yin¹  Yingxue Dong¹  Yunlong Xia²  Yanzong Yang² 

[1] First Affiliated Hospital, Dalian Medical University, Dalian, China;null;

关键词: atrial fibrillation;    E/E′;    recovered ejection fraction;    heart failure;    catheter ablation;   

DOI  :  10.3389/fcvm.2021.707996

 received in 2021-05-11, accepted in 2021-11-22,  发布年份 2022

来源: Frontiers

【 摘 要 】

Aims: Catheter ablation should be considered in patients with atrial fibrillation (AF) and with heart failure (HF) with reduced ejection fraction (EF; HFrEF) to improve survival and reduce heart failure hospitalization. Careful patient selection for AF ablation is key to achieving similar outcome benefits. However, limited data exist regarding predictors of recovered ejection fraction. We aimed to evaluate the predictors of recovered ejection fraction in consecutive patients with HF undergoing AF ablation.Methods and Results: A total of 156 patients [67.3% men, median age 63 (11)] with AF and HF underwent initial catheter ablation between September 2017 and October 2019 in the First Affiliated Hospital of Dalian Medical University. Overall, the percentage of recovered ejection fractions was 72.3%. Recovered EFs were associated with a 39% reduction in all-cause hospitalization compared to non-recovered EFs at the 1-year follow-up [23.8 vs. 62.8 (odds ratio) OR 2.09 (1.40–3.12), P < 0.001]. Univariate analysis for recovered EFs showed that diabetes (P = 0.083), prevalent HF (P = 0.014), prevalent AF (P = 0.051), LVEF (P = 0.022), and E/E′ (P = 0.001) were associated with EF improvement. Multivariate analysis showed that the only independent predictor of EF recovery was E/E′ [OR 1.13 (1.03–1.24); P = 0.011]. A receiver operating characteristic analysis determined that the suitable cut-off value for E/E′ was 15 (sensitivity 38.7%, specificity 89.2%, the area under curve 0.704).Conclusions: Ejection fraction (EF) recovery occurred in 72.3% of patients, associated with a 39% reduction in all-cause hospitalization compared to the non-recovered EFs in our cohort. The only independent predictor of recovered EF was E/E′ < 15 in our series.

【 授权许可】

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Copyright © 2022 Yang, Zhang, Tang, Li, Guan, Yang, Sun, Xiao, Yu, Yin, Dong, Gao, Xia and Yang.