Echocardiographic pattern of left ventricular function recovery in tachycardia‐induced cardiomyopathy patients

Abstract

Abstract Aims Tachycardia‐induced cardiomyopathy (TCM) represents a partially reversible type of cardiomyopathy (CM) that is often underdiagnosed and cardiac chamber remodelling in TCM remains incompletely understood. We aim to explore differences in the dimensions of the left ventricle and functional recovery in patients with TCM compared with patients with other forms of CM. Methods and results We identified patients with reduced ejection fraction (≤50%) and/or atrial fibrillation or flutter with a left ventricular ejection fraction that improved from baseline (≥15% in left ventricular ejection fraction at follow‐up or normalization of cardiac function with at least 10% improvement). Patients were then divided into two groups: (A) TCM patients and (B) patients with other forms of CM (controls). Two hundred thirty‐eight patients were included (31% female, 70 years median age), 127 patients had TCM, and 111 had other forms of CM. Patients with TCM did not significantly improve indexed left ventricular volume (LVEDVI) after treatment (60 [45, 84] mL/m2 versus 56 [45, 70] mL/m2, P = ns) compared with controls (67 [54, 81] mL/m2 versus 52 [42, 69] mL/m2, P 40 mL/m2 (OR 3.4; 95% CI 1.6–7.3, P = 0.001) and normal wall thickness left ventricle (OR 3.2; 95% CI 1.4–7.8, P = 0.008). 54% of patients with TCM demonstrated diastolic dysfunction at follow‐up, without differences from controls (54% vs. 43%, P = ns). 21% of patients with TCM showed persistent heart failure symptoms at follow‐up compared with 4.5% of controls, P = 0.004. Conclusions TCM patients have a specific pattern of functional recovery with persistent remodelling of the left atria and left ventricle. Several echocardiographic parameters might help identify TCM before treatment.

Keywords

• Tachycardia‐induced cardiomyopathy
• Transthoracic echocardiography arrhythmia‐induced cardiomyopathy
• Atrial fibrillation
• Atrial flutter