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- Title
Low troponin I levels predict the presence of arrhythmia-induced cardiomyopathy in patients with atrial fibrillation and left ventricular systolic dysfunction.
- Authors
Aoyama, Daisetsu; Miyazaki, Shinsuke; Tsuji, Toshihiko; Nomura, Ryohei; Kakehashi, Shota; Mukai, Moe; Ikeda, Hiroyuki; Ishida, Kentaro; Uzui, Hiroyasu; Tada, Hiroshi
- Abstract
Successful atrial fibrillation (AF) ablation can improve reduced left ventricular ejection fraction (LVEF) with AF, which is defined as arrhythmia-induced cardiomyopathy (AIC). However, it is difficult to pre-procedurally predict the presence of AIC. We aimed to explore the pre-procedural predictors of AIC in patients with AF and reduced LVEF. This study included 60 patients with a reduced LVEF (LVEF < 50%; 69.1 ± 8.8 years; 45 men) who underwent successful AF ablation. Responders were defined as patients whose LVEF post-procedurally improved to the normal range (≥ 50%). Multivariate analysis revealed that the log-transformed pre-procedural troponin I (TnI) levels (odds ratio [OR] = 0.059; 95% confidence interval [CI] = 0.0052–0.42, p = 0.003) and age (OR = 0.91; 95% CI = 0.82–1.00, p = 0.044) were independent predictors of post-procedural LVEF recovery; further, low TnI levels (< 11.1 pg/ml) predicted LVEF recovery (sensitivity, 79.1%; specificity, 76.5%; positive predictive value, 89.5%; and negative predictive value, 59.1%). There were no significant differences in TnI levels between the baseline and 1 month after the procedure. However, four patients with high baseline TnI levels showed a > 50% reduction in the TnI levels post-procedurally, with three of these patients showing LVEF recovery. Low pre-procedural TnI levels can predict LVEF recovery after successful AF ablation in patients with reduced LVEF.
- Subjects
VENTRICULAR fibrillation; TROPONIN I; ATRIAL fibrillation; VENTRICULAR dysfunction; CARDIOMYOPATHIES
- Publication
Heart & Vessels, 2023, Vol 38, Issue 7, p929
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-023-02242-z