Evidence map›Paper›PMID 39608861›Full record

ArticleOpen heart2024

Characterisation of patients who develop atrial fibrillation-induced cardiomyopathy.

Nikhil Ahluwalia, Shohreh Honarbakhsh, Hakam Abbass, Abhishek Joshi, Anthony W C Chow, Mehul Dhinoja, Steffen Erhard Petersen, Ross J Hunter, Guy Lloyd, Richard J Schilling

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04987723 (A Mechanistic Exploratory Study of AF-induced Cardiac Dysfunction and Symptoms), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04987723 nacompletednot on this map

A Mechanistic Exploratory Study of AF-induced Cardiac Dysfunction and Symptoms

TypeinterventionalSponsorBarts & The London NHS TrustRan2022 to 2024Enrolled106ConditionsAtrial Fibrillation, Heart FailureArmsHolter monitoring, stress echocardiography, Cardiac MRI, Patient questionnaires
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nikhil AhluwaliaSt Bartholomew's Hospital, London, UK.ORCID 0000-0003-1257-5576
Shohreh HonarbakhshSt Bartholomew's Hospital, London, UK.
Hakam AbbassSt Bartholomew's Hospital, London, UK.
Abhishek JoshiSt Bartholomew's Hospital, London, UK.
Anthony W C ChowSt Bartholomew's Hospital, London, UK.
Mehul DhinojaSt Bartholomew's Hospital, London, UK.
Steffen Erhard PetersenWilliam Harvey Research Institute, Queen Mary University of London, London, UK.
Ross J HunterSt Bartholomew's Hospital, London, UK.
Guy LloydSt Bartholomew's Hospital, London, UK.
Richard J SchillingWilliam Harvey Research Institute, Queen Mary University of London, London, UK r.schilling@qmul.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAtrial fibrillation (AF)-induced cardiomyopathy (AIC) is retrospectively defined after normalisation of left ventricular ejection fraction (LVEF) in sinus rhythm. It is unclear why some patients develop AIC. HYPOTHESIS: Patients with AIC have a subtle cardiomyopathic process that precedes their AF-mediated LVEF reduction. Detailed assessment of cardiac function after successful catheter ablation will reveal this.

objectiveTo evaluate the utility of measures to identify cardiomyopathic features that persist after LVEF normalisation in AIC.

methodsPatients with rate-controlled persistent AF and LVEF<50% undergoing catheter ablation (CA) were prospectively evaluated using echocardiography, cardio-pulmonary exercise testing and serum N-terminal pro b-type natriuretic peptide (NT-proBNP) at baseline and 6 months after CA. Participants with AIC, (LVEF recovery (≥50%) and no other cause for cardiac dysfunction) were evaluated using left ventricular (LV) longitudinal strain and left atrial (LA) reservoir strain (LARS). Changes in peak oxygen consumption and the minute ventilation/carbon dioxide production slope were measured as markers of functional capacity and ventilatory inefficiency. A control group of patients with persistent AF with preserved LVEF were also enrolled.

results34/41 (82.9%) participants recovered LVEF in sinus rhythm; defined as AIC. NT-proBNP levels were elevated in 18 (52.9%), and 16 reported ongoing heart failure (HF) symptoms. 10 (29.4%) had no improvement in functional capacity, and seven (20.6%) showed persistent ventilatory inefficiency. 20 (58.8%) had impaired global LV longitudinal strain with a relative apical sparing pattern. Nine (26.5%) had impaired LARS. There was an overlap of these abnormalities. 32 (94.1%) demonstrated at least one, 17 (50.0%) having no cardiovascular risk factors. Patients with preserved LVEF during persistent AF had similar demographics but a lower burden of short R-R intervals (<660 ms) on Holter monitoring. DISCUSSION: Abnormal structural, metabolic and HF biomarkers are seen in patients with AIC in sinus rhythm. These features may represent a precedent subtle cardiomyopathic process predisposing them to left ventricular systolic dysfunction in AF. TRIAL REGISTRATION NUMBER: NCT04987723.

Indexed as

Atrial FibrillationCardiomyopathiesCatheter AblationStroke VolumeVentricular Function, LeftAgedBiomarkersEchocardiographyExercise TestFemaleFollow-Up StudiesHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Atrial FibrillationCardiomyopathiesCatheter Ablation

Identifiers

PMID39608861
PMCPMC11603700

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.