Decreased left atrial global longitudinal strain predicts the risk of atrial fibrillation recurrence after cryoablation in paroxysmal atrial fibrillation
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Authors: Koca, Hasan; Demirtas, Abdullah Orhan; Kaypakli, Onur; Icen, Yahya Kemal; Sahin, Durmus Yildiray; Koca, Fadime; Koseoglu, Zikret; Baykan, Ahmet Oytun; Guler, Emel Celiker; Demirtas, Derya; Koc, Mevlut
Abstract
Purpose We aimed to investigate the association of atrial fibrillation (AF) recurrence with left atrial (LA) strain in nonvalvular paroxysmal AF patients after cryoablation. Methods We included 190 patients who underwent successful cryoablation due to paroxysmal AF. In addition to classical echocardiographic data, LA apical 2-chamber (A2C) strain, LA apical 4-chamber (A4C) strain, and LA global longitudinal strain (LA-GLS) values were calculated by speckle tracking echocardiography. Forty-eight-hour Holter monitoring was performed to all patients no later than 6 months after ablation. Results AF recurrence was detected in 42 patients (22.1%). End-systolic diameter, LA end-systolic diameter, LA-volume, LA-volume index, interatrial septum thickness, coronary sinus diameter, epicardial fat thickness (EFT), and septal E/E & x2cb; ratio were significantly higher, LV-EF, IVRT, septal S and A & x2cb; wave, lateral S wave, LA-A2C strain, LA-A4C strain, and LA-GLS were significantly lower in patients with AF recurrence. LA-GLS, LA-volume index, and EFT were found to be independent parameters for predicting AF recurrence. Conclusions LA-GLS and LAVI should be included in routine evaluations to determine long-term AF recurrence preoperatively.
Optical Coherence Tomography Structural Abnormality Detection in Glaucoma Using Topographically Correspondent Rim and Retinal Nerve Fiber Layer Criteria
AMERICAN JOURNAL OF OPHTHALMOLOGY
Authors: Yang, Hongli; Luo, Haomin; Hardin, Christy; Wang, Yaxing; Jeoung, Jin Wook; Albert, Cindy; Vianna, Jayme R.; Sharpe, Glen P.; Reynaud, Juan; Demirel, Shaban; Mansberger, Steven L.; Fortune, Brad; Nicolela, Marcelo; Gardiner, Stuart K.; Chauhan, Balwantray C.; Burgoyne, Claude F.
Abstract
PURPOSE: This study evaluated the ability of topographically correspondent (TC) minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) criteria to detect optical coherence tomography (OCT) structural abnormality in glaucoma (GL) and glaucoma suspect (GLS) eyes. DESIGN: Retrospective cross-sectional study. METHODS: A total of 196 GL eyes, 150 GLS eyes, and 303 heathy eyes underwent pRNFL and 24 radial optic nerve head OCT imaging and manual correction of the internal limiting membrane, Bruch's membrane opening (BMO), and outer pRNFL segmentations. MRW and pRNFLT were quantified in 6 Garway-Heath or 12 30-degree (clock-hour) sectors. OCT abnormality for each parameter was defined to be less than the 5th percentile of the healthy eye distribution. OCT abnormality for individual eyes was defined using global, sectoral, and combined parameter criteria that achieved >= 95% specificity in the healthy eyes. TC combination criteria required the sectoral location of MRW and pRNFLT abnormality to be topographically aligned and included comMR (a previously reported TC combination consisting of MRW and pRNFLT parameter: [MRW + pRNFLT x (average MRW healthy eyes/average pRNFLT healthy eyes) MRW]. RESULTS: TC sectoral criteria (1 Garway-Heath MRW + corresponding Garway-Heath RNFLT), (one 30-degree MRW + any 1 corresponding or adjacent 30-degree pRNFLT), 30-degree and Garway-Heath comMR-TI and global comMR were the best performing criteria, demonstrating (96%-99% specificity), 86%-91% sensitivity for GL, 80%-84% sensitivity for early GL (MD >= -4.0 dB) and 93%-96% sensitivity for moderate-to-advanced GL (MD < - 4.0 dB). CONCLUSIONS: Clinically intuitive TC MRW and pRNFLT combination criteria identified the sectoral location of OCT abnormality in GL eyes with high diagnostic precision. (C) 2019 Elsevier Inc. All rights reserved.