Left Atrial Strain as Evaluated by Two-Dimensional Speckle Tracking Predicts Left Atrial Appendage Dysfunction in Chinese Patients with Atrial Fibrillation

Abstract

Left atrial appendage (LAA) dysfunction identified by transesophageal echocardiography (TEE) is a powerful predictor of stroke in patients with atrial fibrillation (AF). The aim of our study is to assess if there is a correlation between the left atrial (LA) functional parameter and LAA dysfunction in the AF patients. This cross-sectional study included a total of 249 Chinese AF patients who did not have cardiac valvular diseases and were undergoing cardiac ablation. TEE was performed in all the patients who were categorized into two groups according to their left atrial appendage (LAA) function. A total of 120 of the 249 AF patients had LAA dysfunction. Univariate and multivariate logistic regression was conducted to assess the independent factors that correlated with the LAA dysfunction. Different predictive models for the LAA dysfunction were compared with the receiver operating characteristic (ROC) curve. The final ROC curve on the development and validation datasets was drawn based on the calculation of each area under the curves (AUC). Univariate and multivariate analysis showed that the peak left atrial strain (PLAS) was the most significant factor that correlated with the LAA dysfunction. PLAS did not show inferiority amongst all the models and revealed strong discrimination ability on both the development and validation datasets with AUC 0.818 and 0.817. Our study showed that a decrease in PLAS is independently associated with LAA dysfunction in the AF patients.

Association of Left Atrial Deformation Analysis by Speckle Tracking Echocardiography With Left Atrial Appendage Thrombus in Patients With Primary Valvular Heart Disease

“…We found that the LVEF significantly decreased while LAV (LAVI) substantially increased in the thrombus group compared to the non-thrombus group (P = 0.001). This agrees with the research conducted by Wang et al [ 16 ].…”

Left atrial fibrosis in atrial fibrillation: Mechanisms, clinical evaluation and management

“…Kuppahally et al revealed an inverse association of fibrosis degree assessed by LGE CMR and LA strain, notably in cases of persistent AF in comparison with acute forms 39 . Recent prospective long‐term follow‐up studies demonstrated that longitudinal strain is a potent and independent predictive factor of future AF occurrence in different cohorts 40,41 . Longitudinal strain predicts prognosis in AF, independently of cardiovascular risk factors.…”

“…39 Recent prospective longterm follow-up studies demonstrated that longitudinal strain is a potent and independent predictive factor of future AF occurrence in different cohorts. 40,41 Longitudinal strain predicts prognosis in AF, independently of cardiovascular risk factors.…”

The Correlation between Left Atrial Function by Speckle Tracking and Stroke Risk in Patients with Persistent Atrial Fibrillation

“…Not at all like the ongoing investigation by Wang et al [35], they didn't see the CHA2DS2-VASc score as altogether connected with LAA brokenness, and this score was not a perfect stage to foresee dangers related with stroke utilizing the LAT esteem as a comparator. This irregularity was additionally seen in past investigations [36,37].It is clear that the scoring system includes an assessment of the risks of early stroke, including those that cause vascular wall injury and hypercoagulable status [38].…”