Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Arrhythmia-induced cardiomyopathy (AIC) is defined as impaired left ventricular function due to cardiac arrhythmias. We sought to investigate the association between coronary microvascular dysfunction (CMD) and AIC in patients with atrial fibrillation (AF). METHODS: In this multicenter observational study, we enrolled consecutive patients with recent diagnosis of AF (<6 months) who underwent invasive coronary physiology assessment with the bolus thermodilution technique. Patients were divided into two groups according to left ventricular ejection fraction (LVEF): AIC group if LVEF < 50% and preserved LVEF group if LVEF ≥ 50%. A third group of patients with a recent diagnosis of dilated cardiomyopathy (DCM) and without AF was analyzed as control group. CMD was defined as abnormal coronary flow reserve (CFR < 2.5) and/or abnormal index of microcirculatory resistance (IMR ≥ 25). RESULTS: Among 84 analyzed patients, 33 were in the AIC group, 39 in the preserved LVEF group, and 12 in the DCM group. CMD was more frequently detected in the AIC group compared to the preserved LVEF (79% vs. 38%, p < 0.001) and DCM groups (79% vs. 33%, p = 0.01). In patients with AF, a significant correlation was found between CFR and LVEF (beta coefficient: 3.8; 95% CI: 1.8-5.9; p < 0.001), and IMR and LVEF (beta coefficient: -0.3; 95% CI: -0.4 to -0.1; p = 0.001). At multivariable analysis, CMD was independently associated with AIC (adjusted odds ratio: 6.2; 95% CI: 2.2 to 20.1; p = 0.001). CONCLUSIONS: CMD is strongly and independently associated with the degree of left ventricular dysfunction and may play a role in the development of AIC in patients with AF.
DOI: 10.1002/ccd.31562
Authors: Alice Benedetti, Adriaan Wilgenhof, Gianluca Castaldi, Giovanni M. Vescovo, Enrico Poletti, Valeria Paradies, Tijs Bringmans, Vincent Frans Maria Segers, Koen Ameloot, Edgard Prihadi, Pierfrancesco Agostoni, Carl Convens, Benjamin Scott, Stefan Verheye, Paul Vermeersch, Yves De Greef, Bruno Schwagten, Michael Wolf, Gilles De Keulenaer, Carlo Zivelonghi
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4409780217