Effect of Conversion to Sinus Rhythm on Left Ventricle Regional Myocardial Tissue Velocities in Patients with Lone Atrial Fibrillation

This study was planned to evaluate the effect of canversion to sin us rhythm on left ventricle (LV) regional myocardial tissue velocities by PW tissue Doppler in patients with lone atrial fibrillation (AF). Twenty-seven patients with )one AF were enrolled. PW tissue Doppler tracings of mitral annulus, interventricular septum (IVS), posterior wall and apical segments of LV were obtained. Sm, Em and Am waves were taken as means of the measuremenıs of S consecutive beats. The sinus group was composed by the measurements which were repeated on days 14±2 following canversion to sinus rhythm. The control group w as composed of I O heal thy volunteers having a similar age profile. There were no changes in Sm and Am velocities for each segment when patients were converted to sinus rhythm from AF (p>0.05), whereas there were increase in Am velocities (p<0.05). The Em and Am velocities of all segments were found to be significantly lower than those of the control group (p<0.05) both in patients with AF and sinus rhythm but there were no signific iant differences for Sm velocities. The Sm velocities of IVS of patients when they were in either AF or sinus rhythm were lower than the mitral annulus and free wall and higher than the apical Sm velocities (p<0.05). There were no differences between segments for Em and Am velocities for patients either in AF or sinus rhythm. There was a positive correlation between LV ejection fraction (EF) and mitral annulus Sm velocities when patients were in AF rhythm (r:0.87, p<0.05). The following statements were concluded from the LV myocardial tissue Doppler tracings obtained from patients with !one AF: 1) the decrease in Em wave ve1ocity reflects the increase in LV stiffness and the decrease in elast ic recoil; 2) the decrease in Am wave velocity refl ects the contribution of atrial contraction on myocardial Am wave formatian and Am wave velocity decreases with AF, 3) there is a sig nifi cant positive correlation between mitral annulus Sm ve1ocity and LV EF.