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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
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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0 Themes
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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Comparison of several echocardiographic markers in prediction of atrial fibrillation recurrence after electrical cardioversion: a prospective observational study
Session:
Posters 1 - Écran 09 - Ecocardiografia
Speaker:
João Bicho Augusto
Congress:
CPC 2018
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
João Bicho Augusto; Daniel Candeias Faria; d. Roque; João Baltazar Ferreira; António Freitas; Jose Morais; Victor M. Gil; Carlos Sequeira De Morais
Abstract
<p><strong>Background</strong>: In the past recent years, several echocardiographic markers have been evaluated in prediction of atrial fibrillation (AF) recurrence after electrical cardioversion (EC). Our aim was to evaluate the significance of transthoracic (TTE) and transoesophageal (TOE) echocardiographic markers in the ability to predict AF recurrence after EC.<br /> <strong>Methods</strong>: We prospectively enrolled 35 patients with atrial fibrillation/flutter who underwent EC. All patients had data collected regarding clinical characteristics and biochemical markers before EC. ECG was obtained before and after EC, TOE was performed before EC and TTE was performed before and 15 minutes after cardioversion. TTE parameters before EC included tissue Doppler image-derived Tei index (TDI Tei), peak E wave, E wave deceleration time, lateral e’, septal e’, average E/e’ ratio , anterior-posterior (AP), medial-lateral (ML) and superior-inferior (SI) LA diameters as well as left atrium (LA) volume index. Spontaneous echo contrast (SEC), left atrial appendage (LAA) peak flow velocity, maximum tissue velocity and strain rate were recorded during TOE. Finally, during TTE after EC we recorded TDI Tei, E/A ratio, a’, peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS). Primary outcome was defined as the recurrence of AF at 90 days after EC.<br /> <strong>Results</strong>: Mean age was 68.7±11.4 years, 40.9% males. AF recurrence rate was 38.1%. At univariate analysis, lower septal e’ (p=0.040), higher SI LA diameter (p=0.027) and LAVI (p=0.040), presence of SEC on TOE (p=0.037) and a lower LAA maximum tissue velocity (p=0.044) were predictors of recurrence of AF. No single marker was an independent predictor of AF recurrence. At ROC curve analysis (Figure 1), septal e′ showed the best diagnostic accuracy (AUC 0.863, 95% CI 0.64–0.97, p<0.0001). Optimal cut-off (Youden index) was calculated at septal e’ ≤0.08m/s to predict AF recurrence at 90 days after EC, with a sensitivity=99.9% (CI 95% 59-100%), specificity=69% (39-91%), negative predictive value=99.9%, positive predictive value=76.3%.<br /> <strong>Conclusion</strong>: Normal septal e' values have very high accuracy in predicting sinus rhythm persistence after EC at 90 days follow-up. This tool could be useful in the selection of patients with AF for EC.</p>
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