Strain echocardiographic assessment of left atrial function predicts recurrence of atrial fibrillation

Abstract

AimsWe evaluated if a dispersed left atrial (LA) contraction pattern was related to atrial fibrillation (AF) in patients with normal left ventricular (LV) function, and normal or mildly enlarged left atrium.Methods and resultsWe included 61 patients with paroxysmal AF (PAF). Of these, 30 had not while 31 had recurrence of AF after radiofrequency ablation (RFA). Twenty healthy individuals were included for comparison. Echocardiography was performed in patients in sinus rhythm the day before RFA. LA volume was calculated. Peak negative longitudinal strain was assessed in 18 LA segments during atrial systole. Contraction duration in 18 LA segments was measured as the time from peak of the P wave on electrocardiogram to maximum myocardial shortening in each segment. The standard deviation of contraction durations was defined as LA mechanical dispersion (LA MD). LA size was rather preserved in patients with PAF (LA volume 25 ± 10 mL/m2). LA MD was more pronounced in patients with recurrence of AF after RFA compared with those without recurrence and controls (38 ± 14 ms vs. 30 ± 12 ms vs. 16 ± 8 ms, both P < 0.001). LA MD was a predictor of PAF [OR 7.84 (95%CI 2.15–28.7), P < 0.01, per 10 ms increase] adjusted for age, LA volume, e’, and LA function. LA function by strain was reduced in both patients with and without recurrent AF after RFA compared with controls (−14 ± 4% vs. −16 ± 3% vs. −19 ± 2%, both P < 0.05).ConclusionLA MD was pronounced, and LA deformation was reduced in patients with PAF with apparently normal LV structure and function, and normal or mildly enlarged LA. LA MD may be useful as a predictor of AF recurrence after RFA.

Left atrial function in children and young adult cancer survivors treated with anthracyclines

“…For example, diastolic dysfunction is more strongly linked to LA health than LV health . Additionally, LA function is a strong prognosticator in heart failure, and has been shown to predict the recurrence of atrial fibrillation in patients with normal LV function . In adults, anthracycline exposure is associated with a significant change in LA GLS .…”

“…7 Additionally, LA function is a strong prognosticator in heart failure, 7 and has been shown to predict the recurrence of atrial fibrillation in patients with normal LV function. 8 In adults, anthracycline exposure is associated with a significant change in LA GLS. 9 In survivors of pediatric cancer exposed to anthracyclines, peak negative LA strain, 10 LA reservoir, and LA booster pump function were reduced.…”

Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

“…A 2D strain analysis enables identification of these phases. Various studies have demonstrated impaired LA global and regional function in patients with paroxysmal AF despite a normal or mildly enlarged LA (8)(9)(10) . As demonstrated by the present study, impairment in the reservoir function was detected even before atrial dilatation occurred.…”

Predictive value of unshielded magnetocardiographic mapping to differentiate atrial fibrillation patients from healthy subjects

“…Alterations of atrial conduction and/or refractoriness and increased left atrium (LA) size are related to both genesis and maintenance of AF (Jurkko et al, ; Sarvari et al, ) with reciprocal relationship between AF and electrophysiological and/or structural remodelling due to atrial cardiomyopathy (Goette et al, ).…”