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Assessment of Left Atrial Function in Patients with Paroxysmal, Persistent, and Permanent Atrial Fibrillation Using Two-Dimensional Strain.

Background and purpose: Atrial fibrillation has a progressive nature. It initiates structural functional and electrical changes in the left atrium (LA). Enhanced response to treatment in patients with this disease can be achieved through the improved knowledge of atrial structure and better understanding of its function. The aim of this study was to assess the LA strain and its determinants in patients with paroxysmal (PAF), persistent (PsAF) and permanent AF (PmAF). Methods: 58 patients with registered nonvalvular AF were divided into 3 groups depending on the type of AF. The participants underwent transthoracic echocardiography to assess the anatomy and function of four chambers. Left atrial longitudinal strain (LALS) using two-dimensional speckle-tracking (STE) was measured in the apical 4-chamber view (A4C). Data were analyzed using STATISTICA 13. Results: Patients with PAF had higher LALS (15.7±12.0) compared with those with PsAF (4.3±7.9) and PmAF (5.8±7.8, all P=0.003). Multiple linear regression showed that the independent predictors of LALS were diastolic blood pressure (β=0.95, R2=0.88) in the PAF group; left atrial area (β=-0.56) and creatinine (β=-0.63, R2=0.58) in the PsAF group; AF length (β=0.89) in the PmAF group (R2=0.72). Conclusion: LA strain has different determinants depending on AF type. LA size, renal function, AF length determine LALS in long-lasting AF. The LA strain is a simple and accurate technique to estimate LA dysfunction in patients with long-lasting AF .

Credits: Aleksandra Lenart-Migdalska, Magdalena Ka?nica-Wiatr, Leszek Drabik, Klaudia Knap, Monika Sma?-Suska, Prof. Piotr Podolec, Prof. Maria Olszowska

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