RELATIONSHIP BETWEEN GLOBAL LONGITUDINAL STRAIN AND INCIDENT ATRIAL FIBRILLATION IN THE GENERAL POPULATION: THE COPENHAGEN CITY HEART STUDY

Abstract Background Low-voltage zone (LVZ) in the left atrium (LA) seems to represent fibrosis. LA longitudinal strain assessed by speckle tracking method is known to correlate with the extent of fibrosis in patients with mitral valve disease. Purpose We sought to identify the relationship between LA longitudinal strain and LA bipolar voltage in patients with atrial fibrillation (AF). We tested the hypothesis that LA strain can predict LA bipolar voltage. Methods A total of 96 consecutive patients undergoing initial AF ablation were analyzed. All patients underwent transthoracic echocardiography including 2D speckle tracking measurement on the day before ablation during sinus rhythm (SR group, N=54) or during AF (AF group, N=42). LA longitudinal strain was measured at basal, mid, and roof level of septal, lateral, anterior, and inferior wall in apical 4- and 2-chamber view. Global longitudinal strain (GLS) was defined as an average value of the 12 segments. LA voltage map was created using EnSite system, and global mean voltage was defined as a mean of bipolar voltage of the whole LA excluding pulmonary veins and left atrial appendage. LVZ was defined as less than 1.0 mV. Results There was a significantly positive correlation between GLS and global mean voltage (r=0.708, p<0.001). Multivariate regression analysis showed that GLS and age were independent predictors of global mean voltage. There was a significant negative correlation between global mean voltage and LVZ areas. Conclusions There was a strong correlation between LA longitudinal strain and LA mean voltage. GLS can independently predict LA mean voltage, subsequently LVZ areas in patients with AF. Funding Acknowledgement Type of funding source: None

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Impact of rhythm in non-valvular atrial fibrillation on four cardiac chamber deformation imaging

European Heart Journal ◽

10.1093/ehjci/ehaa946.0139 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Philabout ◽

L Soulat-Dufour ◽

I Benhamou-Tarallo ◽

S Lang ◽

S Ederhy ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Cardiac Rhythm ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Cardiac Chamber ◽

Deformation Imaging ◽

And Function

Abstract Background Few studies have assessed the evolution of cardiac chambers deformation imaging in patients with atrial fibrillation (AF) according to cardiac rhythm outcome. Purpose To evaluate cardiac chamber deformation imaging in patients admitted for AF and the evolution at 6-month follow-up (M6). Methods In forty-one consecutive patients hospitalised for AF two-dimensional transthoracic echocardiography was performed at admission (M0) and after six months (M6) of follow up. In addition to the usual parameters of chamber size and function, chamber deformation imaging was obtained including global left atrium (LA) and right atrium (RA) reservoir strain, global left ventricular (LV) and right ventricular (RV) free wall longitudinal strain. Patients were divided into three groups according to their cardiac rhythm at M0 and M6: AF at M0 and sinus rhythm (SR) at M6 (AF-SR) (n=23), AF at M0 and AF at M6 (AF-AF) (n=11), SR at M0 (spontaneous conversion before the first echocardiography exam) and SR in M6 (SR-SR) (n=7) Results In comparison with SR patients (n=7), at M0, AF patients (n=34)) had lower global LA reservoir strain (+5.2 (+0.4 to 12.8) versus +33.2 (+27.0 to +51.5)%; p<0.001), lower global RA reservoir strain (+8.6 (−5.4 to 11.6) versus +24.3 (+12.3 to +44.9)%; p<0.001), lower global LV longitudinal strain (respectively −12.8 (−15.2 to −10.4) versus −19.1 (−21.8 to −18.3)%; p<0.001) and lower global RV longitudinal strain (respectively −14.2 (−17.3 to −10.7) versus −23.8 (−31.1 to −16.2)%; p=0.001). When compared with the AF-SR group at M0 the AF-AF group had no significant differences with regard to global LA and RA reservoir strain, global LV and RV longitudinal strain (Table). Between M0 and M6 there was a significant improvement in global longitudinal strain of the four chambers in the AF-SR group whereas no improvements were noted in the AF-AF and SR-SR group (Figure). Conclusion Initial atrial and ventricular deformations were not associated with rhythm outcome at six-month follow up in AF. The improvement in strain in all four chambers strain suggests global reverse remodelling all cardiac cavities with the restoration of sinus rhythm. Evolution of strain between M0 and M6 Funding Acknowledgement Type of funding source: None

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PROGNOSTIC IMPORTANCE OF LEFT VENTRICULAR MECHANICAL DYSSYNCHRONY IN PREDICTING CARDIOVASCULAR DEATH IN THE GENERAL POPULATION: THE COPENHAGEN CITY HEART STUDY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31997-1 ◽

2018 ◽

Vol 71 (11) ◽

pp. A1456

Author(s):

Daniel Modin ◽

Sofie Reumert Biering-Sørensen ◽

Rasmus Møgelvang ◽

Jan Jensen ◽

Tor Biering-Sorensen

Keyword(s):

General Population ◽

Cardiovascular Death ◽

Mechanical Dyssynchrony ◽

Left Ventricular ◽

Heart Study ◽

Left Ventricular Mechanical Dyssynchrony ◽

Prognostic Importance ◽

Copenhagen City Heart Study

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Global longitudinal strain corrected by RR-interval is a superior echocardiographic predictor of outcome in patients with atrial fibrillation

International Journal of Cardiology ◽

10.1016/j.ijcard.2018.02.038 ◽

2018 ◽

Vol 263 ◽

pp. 42-47 ◽

Cited By ~ 6

Author(s):

Maria Dons ◽

Jan Skov Jensen ◽

Flemming Javier Olsen ◽

Martina Chantal de Knegt ◽

Thomas Fritz-Hansen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Rr Interval

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Decreased left atrial global longitudinal strain predicts the risk of atrial fibrillation recurrence after cryoablation in paroxysmal atrial fibrillation

Journal of Interventional Cardiac Electrophysiology ◽

10.1007/s10840-019-00573-4 ◽

2019 ◽

Vol 58 (1) ◽

pp. 51-59

Author(s):

Hasan Koca ◽

Abdullah Orhan Demirtas ◽

Onur Kaypaklı ◽

Yahya Kemal Icen ◽

Durmus Yıldıray Sahin ◽

...

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Left Atrial ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Atrial Fibrillation Recurrence

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3226The impact of cardiovascular risk factors on global longitudinal strain over a ten-year period in the general population: The Copenhagen City Heart Study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0045 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K G Skaarup ◽

M C H L Lassen ◽

S R B S Biering-Soerensen ◽

P G J Joergensen ◽

M A Appleyard ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Smoking Status ◽

Global Longitudinal Strain ◽

Spline Curves ◽

Heart Study ◽

Male Sex ◽

The Impact

Abstract Background Global longitudinal strain (GLS) of the left ventricle (LV) has proved to be a strong predictor of cardiovascular morbidity and mortality. GLS declines throughout adult-life as the LV remodels and adapts. Information on the impact of cardiac risk factors such as male sex, obesity, smoking status, hypertension, hypercholesterolemia, and diabetes on GLS through time has not yet been investigated. Purpose The aim of the present study was to investigate the impact of age, sex, body mass index (BMI), smoking status (current and previous vs never), mean arterial blood pressure (MAP), total plasma cholesterol (TPC), and HbA1c on GLS in the general population over a 10-year period. Method A total of 689 citizens recruited from the general population participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5) a prospective longitudinal study. At CCHS4 the mean age was 51 years and 45% were male. The average decline in GLS during the follow-up period was −0.65%. All participants underwent two echocardiographic examinations median 10.4 [IQR: 10.2, 10.9] years apart along with thorough health examinations. All analyses were adjusted for baseline GLS value (CCHS4 value). Results In regression models, increasing age, male sex, increasing BMI, MAP, hypertension, increasing HbA1c, and diabetes proved to be significantly associated with increased decline in GLS. Relationship between significant continuous cardiovascular risk factors and ΔGLS are displayed in restricted spline curves (Figure 1). In a multivariable regression model including all the investigated cardiovascular risk factors, estimated glomerular filtration rate, plasma pro B-type natriuretic peptide, heart rate, and previous ischemic heart disease, age (standardized β-coef. = −0.10, P=0.005), male sex (standardized β-coef. = −0.16, P<0.001), and MAP (standardized β-coef. = −0.07, P=0.009) remained independent predictors of an accelerated decline in GLS during a 10-year period. Restricted cubic spline curves Conclusion In the general population increasing age, male sex, and increasing MAP are all independently associated with an accelerated decline in GLS over a 10-year period.

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