Left atrial dimension and atrial fibrillation in surgical heart disease patients

Objective The effect of left atrial (LA) dimension on the occurrence of atrial fibrillation (AF) has been examined in some small studies. Less is known about the relationship of LA dimension, hemodynamic with AF during echocardiographic evaluation, especially, the flow dynamics in LA poorly described. The objective of this study was to investigate the relationship between LA dimension and the occurrence of AF. Methods Two hundred and forty-five consecutive patients with heart disease scheduled to undergo open heart surgery were prospectively enrolled in the study. Patients were divided into 2 groups according to atrial fibrillation: AF group (n=148, 99 men and 49 women, with a mean age 59.3±8.4 years), and no-AF group (n= 97, 60 men and 37 womem). Echocardiography was performed before surgery. All measurements were performed following the American Society of Echocardiography recommendations. Results There were more patients with congestive heart failure in AF group than in no-AF group (45.9% vs 39.1%, P <0.05). The mean LA volume was 49.2±12.2 ml/m2 in AF group and 33.1±10.8 ml/m2 in no-AF group. There were also significant differences between two groups in left atrial end systolic dimension (LAESD) (50±13mm vs 27±14mm), left atrial end diastolic dimension (LAEDD ) (79±17mm vs 53±13mm), PA pressure ( 41.3±11.6 mmHg vs 37.5±10.4 mmHg), and ratio of mitral E velocity and septal mitral annulus motion velocity ( E/E’) .The percentage of abnormal diastolic function grades (DGF) was also higher in AF than in no-AF group (89.9% versus 59.8% );. Conclusion Atrial fibrillation is associated more frequently with an increased LA dimension and more severe atrial hemodynamics disorder.