Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

E/e’ ratio Predicts the Atrial Pacing-induced Left atrial Pressure Response in Patients with Preserved Ejection Fraction

Version 1 : Received: 8 March 2021 / Approved: 15 March 2021 / Online: 15 March 2021 (13:02:14 CET)

How to cite: Roh, S.; Lee, K.; Baek, Y.; Iqbal, M.; Jena, A.; Tseveendee, S.; Shim, J.; Choi, J.; Kim, Y. E/e’ ratio Predicts the Atrial Pacing-induced Left atrial Pressure Response in Patients with Preserved Ejection Fraction. Preprints 2021, 2021030382 (doi: 10.20944/preprints202103.0382.v1). Roh, S.; Lee, K.; Baek, Y.; Iqbal, M.; Jena, A.; Tseveendee, S.; Shim, J.; Choi, J.; Kim, Y. E/e’ ratio Predicts the Atrial Pacing-induced Left atrial Pressure Response in Patients with Preserved Ejection Fraction. Preprints 2021, 2021030382 (doi: 10.20944/preprints202103.0382.v1).

Abstract

Introduction: Left atrial hypertension is one of the pathophysiologies of heart failure with preserved ejection fraction. We hypothesized that left atrial pressure response (LAPR) to incremental pacing is higher in patients with atrial fibrillation (AF) and can predict left ventricular diastolic dysfunction. Methods: Patients requiring left atrial access as a part of a therapeutic procedure for AF (n=204, AF group) or supraventricular tachycardia (n=34, control group) were analyzed (male n=183, 54±12 years old). LAPR was measured during incremental pacing. Results: Baseline left atrial pressure and LAPR at all pacing rates were not different between the AF and control groups. They were higher in patients with a high E/e’ (≥ 8) than in those with a low E/e’ (< 8). LAPR at a pacing interval of 400ms and E/e' were positively correlated (r=0.373, p<0.001). Body mass index and a high E/e' were independent predictors of pacing-induced left atrial hypertension. Conclusions: The LAPR to incremental pacing was constant regardless of AF. The non-invasive echocardiographic marker E/e' reflected pacing-induced left atrial hypertension.

Keywords

diastolic dysfunction; heart failure; atrial fibrillation; atrial hypertension; left atrial pressure

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