RESULTS
One hundred and forty two patients aged 63(58-67) years old, 117 males (82%), were enrolled in our study. The median continuous AF duration was 24(12-36) months, range from 12-204 months and median LA anteroposterior diameter was 47(45-50)mm, ranging from 31-63mm. Further detailed data on patient characteristics and echocardiographic findings are presented in Table 1.
LVA were detected in 54% (77/142) of the patients. Severe global LVA burden was present in 15% (21/142, 27% of the patients with LVA), whereas 30% of the patients (42/142, 55% of the patients with LVA) presented a disseminated pattern of remodelling. Twenty five percent of the patients (36/142) had documented LVA on the septum, 31% (44/142) on the anterior wall, 42% (59/142) on the posterior wall, 24% (34/142) on the inferior wall, and 10% (20/142) on the lateral wall.
No differences were found among RA dataset in patients presenting LVA and disseminated pattern of LVA remodelling. However, patients with severe LVA burden showed significantly longer RA maximum and minimum length, larger maximum and minimum RA indexed area and biatrial maximum and minimum area (Table 2).
Using an univariate logistic regression technique it was found that none of the RA indices were associated with the prediction of the LVA, severe LVA or a disseminated LVA pattern.
Further analysis revealed that RA maximum volume had a positive correlation with the presence of mild-to-moderate TR (r=0.24, p=0.0009) and CHA2DS2VASc score ≥4 (r=0.22, p=0.01). The presence of RA enlargement positively correlated with TR (r=0.23, p=0.02) and LVH (r=0.2, p=0.02). Moreover both RA maximum volume and the presence of RA enlargement positively correlated with the presence of LA enlargement (r=0.2, p=0.04), maximum LA volume (r=0.44, p<0.0001) and area (r=0.43, p<0.0001). Right-to-left maximum volume ratio > 100% had a positive correlation with TR (r=0.23, p=0.016), LVH (r=0.2, p=0.02), and an inverse correlation with female sex (r=-0.2, p=0.035). Right-to-left maximum area ratio > 100% had an inverse correlation with female sex (r=-0.2, p=0.03). Biatrial maximum volume had a positive correlation with age (r=0.23, p=0.026) and LVH (r=0.37, p<0.0001), whereas biatrial maximum area had a correlation with age (r=0.28, p=0.002), LVH (r=0.37, p<0.0001), CHA2DS2VASc score ≥4 (r=0.24, p=0.01) and inversely correlated with BMI (r=-0.34, p<0.0001). No correlations between RA features and AF duration along with concomitant diseases other than those included in the CHA2DS2VASc score were found.