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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Multimodality imaging assessment of left atrial size methods in patients with atrial fibrillation
Session:
CO 08 - Ecocardiografia
Speaker:
Ana Vera Marinho
Congress:
CPC 2018
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Comunicações Orais
FP Number:
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Authors:
Ana Vera Marinho; Patrícia M. Alves; James Milner; Célia Domingues; João André Ferreira; João Marques; Paulo Mendes; Natália António; Pedro Sousa; Luis Elvas; Rui M. Martins; Francisco Gonçalves; Mariano Pêgo
Abstract
<p><strong>Introduction </strong>Left atrial (LA) size has been shown to be a significant predictor of cardiovascular outcomes. Current guidelines recommend determination of LA volume for assessment of LA geometry. However, there are multiple 2D and 3D methods to estimate LA size and the best echocardiographic parameter to estimate LA volume is to be determined. Patients with atrial fibrillation are a particularly challenging subset where atrial dimensions are important for prognosis and to predict ablations results.</p> <p><strong>Aim </strong>We aim to comparatively assess the performance of LA size parameters measured by 2D and 3D echocardiography in comparison with LA volume measured by computed tomography (CT) in patients with atrial fibrillation (AF).</p> <p><strong>Methods </strong>We prospectively included 80 consecutive patients with AF referred for AF ablation in our Centre that underwent cardiac CT prior to the procedure. 2D echocardiographic parameters included diameters, LA area (planimetry) and LA volume (disk summation algorithm). 3D quantification of LA volume was performed offline on a EPIQ 7 US. CT imaging was performed as gold-standard using a standard 64-slice CT coronary angiography and LA volumes were determined by summation of discs method.</p> <p><strong>Results </strong>The mean age of cohort was 58 ± 10 years and 59 % were men. Regarding to prevalence of cardiovascular risk factors, 58% of patients had hypertension, 47% had dyslipidemia, 18% were smokers, and 6% had sleep apnea. The mean body mass index was 27. 6 ± 5.5. The majority had paroxysmal AF (78%) and the mean CHA2DS2VASC score was 1.10 ± 1. Mean LAV measured by CT was significantly higher compared do 2D echo disk summation algorithm (130 ± 51ml vs. 60 ± 27, p< 0.001). Also, mean LA volume using 3D evaluation were significantly lower compared to CT evaluation (130 ± 51ml vs.100± 30ml, p=0.02). 3D echo measurement correlated and agreed well with CT (r = 0.87, R = 0.80, p<0.001). However, linear measurements by M mode had a poor correlation with CT (r=0.468, R=0.30, p=0.01), as well as area (r=0.531, R=0.31, p<0.01). Interestingly, 2D diameter correlates better with CT than biplane volume r=0.64, R=0.4, p<0.001 and r=0.60, R= 0.7,p<0.001 respectively). ROC curves (figure1) show that 3D echo LA volume has the best accuracy for assessing LA enlargement.</p> <p><strong>Conclusions: </strong>In patients with AF, 3D echo-derived LA volume, performs better than other 2D-derived parameters for assessing LA size. Therefore, it should be the preferred method for evaluating LA size non-invasively. It lacks radiation and offers additional diagnostic accuracy comparing to 2D echocardiographic parameters. </p>
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