Characteristics of left atrial strain in patients with atrial fibrillatio after cardioversion

The aim of the study – to evaluate the parameters of left atrial myocardial strain in patients with atrial fibrillation who underwent electrical and drug cardioversion.Materials and methods. The study included 118 patients of the University Clinical Hospital No 1 of the First Sechenov Moscow State Medical University. The analysis was carried out in three groups of patients: group 1 (n=54) – patients with atrial fibrillation who underwent electrical cardioversion; group 2 (n=31) – patients with atrial fibrillation who underwent drug cardioversion; group 3 (n=43) – patients without a history of atrial fibrillation. The clinical and anamnestic data of the medical history of each patient, as well as ultrasound indicators were evaluated: global strain of the left atrial, the values of negative peaks as a reflection of the left atrial systole and the values of positive peaks as a reflection of the filling of the left atrium, LASI – the left atrial stiffness index.Results. The analysis showed that left atrial strain in patients with atrial fibrillation were reduced in all analyzed parameters: negative strain peaks (-9.00 vs. -12.6 in the control group, p<0.001), positive strain peaks (12.6 vs. 14.6 in the control group, p<0.001), global left atrial strain (21.5 in the atrial fibrillation group vs. 27.3 in the control group, p<0.001). Left Atrial Stiffness Index (LASI) was significantly higher in patients with a stopped episode of atrial fibrillation (0.50 vs. 0.40, p=0.006).Conclusions. The indicators of left atrial strain were significantly reduced, and the left atrial stiffness index was significantly increased both in the group with electrical cardioversion and in the group with drug-induced cardioversion, compared with patients with similar cardiovascular pathologies, but without a history of atrial fibrillation episodes.

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Abstract 13086: Left Atrial Function in Adult With Normally Functioning Bicuspid Aortic Valves

Circulation ◽

10.1161/circ.142.suppl_3.13086 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Mingxing XIE ◽

Deng Wenhui ◽

Wang Jing

Keyword(s):

Blood Pressure ◽

Left Atrial ◽

Clinical History ◽

Stiffness Index ◽

Lv Function ◽

Sinus Of Valsalva ◽

Left Atrial Strain ◽

History Of ◽

Atrial Strain ◽

Left Atrial Dysfunction

Background: Bicuspid aortic valve is a complicated and heterogeneous disease that has aroused great interest in recent years. Traditionally the greatest attention during a routine echocardiography is paid to the function of the ventricles and aortopathy, much less is known about dysfunction the left atrium. The objective of this study was to characterize left atrial strain (LAS) and functions by two-dimensional speckle tracking echocardiography in adult BAV with normally functioning, and interrogate the risk factors. Methods: This is a prospective cohort study of 52 patients (age 40.23±11.29 years) and 33 healthy volunteers (aged 39.12±12.74 years) were recruited. All subjects included in both groups were in sinus rhythm and no clinical history of cardiovascular diseases. We mainly assessed left atrial reservoir, pump, and conduit function using 2D STE, then determined relationships among indices of segmental aortic stiffening, BAV cusp fusion pattern, LV diastolic function indices and LA deformation. Results: Without adjustment, the indices of LA functions in patients with BAV were significantly decreased compared with controls (LAS 49.41 ± 11.14 vs 59.48 ± 9.53, p<0.001, LAEF 71.56 ± 6.57 vs 76.36 ± 5.72, p=0.001; LAS-passive 29.43 ± 9.42 vs 36.67 ± 9.60, p=0.001, LAEF-passive 43.72 ± 10.78 vs 49.58 ± 6.80, p=0.003). However, after adjustment on age, gender, systolic blood pressure, diastolic blood pressure, BSA ,only the LAS was lowering (p<0.001). With or without adjustment, the ascending aorta of patients with BAV were still stiffer at each segment compared with controls. As parameters of LV diastolic functions, the E/e’ ratio (p=0.01) and e’ value (p=0.01) were significantly altered. The LA volume were increased in BAV patients (59.33 ± 19.12 vs 46.10 ± 9.73). In patients with BAV, LA functions, LV functions and segmental aortic stiffness were not influenced by the Sivere valve types. In multiple regression analysis, the stiffness at the sinus of Valsalva were independently correlated with LAS (adjust R 2 = 0.82, β = -0.33, p<0.001). Conclusion: Left atrial dysfunction is common in adult BAV with normally functioning. LA dysfunction is associated with stiffness index at the sinus of Valsalva, and is independent of LV function.

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Speckle echocardiographic left atrial strain and stiffness index as predictors of maintenance of sinus rhythm after cardioversion for atrial fibrillation: a prospective study

Cardiovascular Ultrasound ◽

10.1186/1476-7120-10-48 ◽

2012 ◽

Vol 10 (1) ◽

Cited By ~ 40

Author(s):

Amir Y Shaikh ◽

Abhishek Maan ◽

Umar A Khan ◽

Gerard P Aurigemma ◽

Jeffrey C Hill ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Prospective Study ◽

Left Atrial ◽

Stiffness Index ◽

Left Atrial Strain ◽

Atrial Strain ◽

A Prospective Study

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Abstract 17186: Left Atrial Strain Predicts Adverse Outcomes in Hypertrophic Cardiomyopathy

Circulation ◽

10.1161/circ.138.suppl_1.17186 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Nestor Vasquez ◽

Benjamin Ostrander ◽

Dai-Yin Lu ◽

Ioannis Ventoulis ◽

Bereketeab Haileselassie ◽

...

Keyword(s):

Atrial Fibrillation ◽

Hypertrophic Cardiomyopathy ◽

Left Atrial ◽

Univariate Analysis ◽

Composite Endpoint ◽

Adverse Outcomes ◽

Left Atrial Strain ◽

Increased Risk ◽

History Of ◽

Atrial Strain

Introduction: Hypertrophic cardiomyopathy (HCM) patients are at increased risk for heart failure (HF), stroke, death, and paroxysmal atrial fibrillation (PAF) development. There is no consensus whether atrial fibrillation (AF) is a marker or mediator of adverse outcomes in HCM patients. Hypothesis: We hypothesized that PAF and left atrial (LA) remodeling predict adverse outcomes in HCM. Methods: Echocardiography (2D and speckle tracking) was used to assess LA size, function, and mechanics in a cohort of HCM patients with history of PAF (PAF group, n=45) and age/gender-matched HCM patients without history of AF (No-AF group; n=59). AF was diagnosed by review of EKGs, event recorder/holter monitor data, and ICD interrogation. Patients were followed for a mean of 53 months for development of the composite endpoint of HF, death, and stroke. Results: Clinical/demographic characteristics were similar in the 2 groups; 67% of PAF group had a CHADS 2 VASC score ≤ 1. The PAF group had higher LA volume, lower LA ejection fraction, and higher E/A ratio (reflecting LV diastolic dysfunction) compared to the No-AF group. LA contractile and reservoir strain/strain rate (SR) were significantly lower in the PAF group (Table 1). Male gender, LA reservoir and conduit strain/SR (not PAF presence) were associated with the development of the composite endpoint in univariate analysis. Only LA conduit and reservoir strain/SR independently predicted the composite endpoint in a multivariate model. Kaplan Meier survival analysis showed greater event-free survival among HCM patients with LA conduit strain >10.2% (Figure 1a) and LA reservoir strain >23.8% (p < 0.01) (Figure 1b). Conclusions: PAF is associated with greater degree of LA myopathy in HCM. LA myopathy assessed by conduit and reservoir strain/SR may be useful for risk stratification for HF, stroke, and death in HCM.

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