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Fusco F, Scognamiglio G, Sorice D, Abbate M, Altobelli I, Sarubbi B. Biventricular performance in adults with a systemic right ventricle: new insights from myocardial work analysis. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1067-1079. [PMID: 38578362 DOI: 10.1007/s10554-024-03076-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024]
Abstract
To evaluate biventricular mechanics by means of echo-derived myocardial work (MW) analysis in patients with a systemic right ventricle (sRV). Comprehensive echo data were collected in all patients with a sRV who underwent transthoracic echocardiography at our tertiary centre between 2020 and 2021 including sRV function indices, global longitudinal strain (GLS) of right and left ventricle (RV/LV), biventricular MW, and atrial strain in those with congenitally corrected transposition of the great arteries (ccTGA). Fifty-six patients (37 [30.97-45.87]years, 59% male) and 49 healthy individuals matched per age and sex were included for comparison. Global work index (GWI:1106 [869.80-1293.10] Vs 314.2 [281.5-358.2]mmHg%, p < 0.0001) and global constructive work(GCW: 1542.50 [1338.9-1718.50] Vs 416.4 [365.70-464]mmHg%, p < 0.0001) were both increased for sRV compared to normal RV, reflecting exposition to a systemic afterload, with a contemporary raise in wasted work (GWW:197 [138.50-322.20] Vs 26.09 [17.80-43.48]mmHg%, p < 0.0001) and impaired efficiency (GWE:89 [83-93.54] Vs 93.67 [91.67-96] %, p < 0.0001). Conversely, sRV showed reduced MW indices in comparison to normal LV(p < 0.0001 for all). Non-systemic LV demonstrated normal GLS values (19.51 ± 3.9%), but reduced GWI (479 [368-665] Vs 2172 [1978-2386]mmHg%, p < 0.0001) and GCW (708 [490-815]mmHg% Vs 86.5 [59.25-118], p < 0.0001). Nevertherless, non-systemic LV showed also impaired efficiency (91 [88-94] Vs 95 [94-97]%, p < 0.0001). LVGLS values were related to RVGLS (R = 0.5, p = 0.00019), suggesting a consistent interventricular dependency. Atrial strain could be assessed in 16 out of 20 (80%) patients with ccTGA: both atria had reduced strain values compared to their normal counterparts. Moreover, pulmonary atrial strain during the reservoir phase was related to LVGWE (R = 0.58, p = 0.047) and inversely related to LVGLS (R = - 0.71, p = 0.0043). MW analysis is feasible in sRV and may provide additional clinical data. In our cohort MW revealed biventricular impairment, in particular for non-systemic LV, in spite of normal GLS values.
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Affiliation(s)
- Flavia Fusco
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
| | - Giancarlo Scognamiglio
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Davide Sorice
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Massimiliana Abbate
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Ippolita Altobelli
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
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Mutluer FO, Bowen DJ, van Grootel RWJ, Kardys I, Roos-Hesselink JW, van den Bosch AE. Prognostic value of left atrial strain in patients with tetralogy of fallot. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:527-534. [PMID: 38117377 DOI: 10.1007/s10554-023-03020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
To demonstrate prognostic utility of left atrial strain (LAS) in adult patients with repaired Tetralogy of Fallot (rTOF). Adults patients with rTOF were prospectively enrolled in this study between years 2011 and 2015. Left atrium (LA) phasic functions were assessed using 2D speckle tracking echocardiography. Association of LA strain (LAS) with primary (any cardiovascular event) and secondary (death, heart failure or arrhythmia) composite endpoints was assessed using Cox regression analysis. Hundred-and-twelve rTOF patients, in whom LAS was feasible and were in sinus rhythm, were included in the final analysis (age 33 ± 10 years, 68[61%] male). Median duration of follow-up was 8.6 [4.2-9.7] years in the study group. Primary composite endpoint was reached in 48 patients (mean event-free survival time: 7.2 [6.6-7.9] years), and secondary composite endpoint was reached in 22 patients (mean event-free survival time: 8.7 [8.1-9.2] years). LA reservoir strain (LAS-r) was defined as tertile groups (1st tertile < 33%, 2nd tertile = 33-44%, 3rd tertile > 44%). Decreasing tertiles of LAS-r was associated with primary and secondary composite endpoints in Kaplan-Meier analysis (p = 0.02 and 0.002, respectively). In univariable Cox-regression, both decreasing LAS-r and LAS-r tertiles were associated with primary and secondary composite endpoints. Adjusted by initial repair age and NT-proBNP quartiles, increased LAS-r was associated with significantly decreased occurrence of experiencing any events (HR = 0.97, CI 0.93-0.99, p < 0.001). Decreasing LAS-r was still associated with primary endpoint when adjusted by left atrium volume index (LAVImax) (HR = 0.96, CI 0.92-0.99, p = 0.01), left ventricle global longitudinal strain (HR = 0.96, CI 0.93-0.99, p < 0.001) or right ventricle free wall longitudinal strain (HR = 0.96, CI 0.93-0.99, p = 0.03). Assessment of LA mechanics with the use of STE has incremental utility in determination of mortality and morbidity in rTOF, and may be implemented in clinical practice.
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Affiliation(s)
- Ferit Onur Mutluer
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Yeditepe University Hospital, Istanbul, Turkey.
| | - Daniel J Bowen
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Roderick W J van Grootel
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Isabella Kardys
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jolien W Roos-Hesselink
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Annemien E van den Bosch
- Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, 'S-Gravendijkwal 230, 3015 CE Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Yang Y, Liu B, Ji W, Ding J, Tao S, Lian F. Comparison of left atrial and left atrial appendage mechanics in the recurrence of atrial fibrillation after radiofrequency catheter ablation. Echocardiography 2023; 40:1048-1057. [PMID: 37548034 DOI: 10.1111/echo.15670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/15/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVES Although radiofrequency catheter ablation (RFCA) has become an important treatment strategy for paroxysmal or persistent atrial fibrillation (AF), AF recurrence after RFCA remains an important issue that plagues clinicians and patients. This study aimed to investigate the association of left atrial (LA) and left atrial appendage (LAA) mechanics with AF recurrence after RFCA and to compare their prognostic values in patients with AF undergoing RFCA. METHODS A total of 160 patients with non-valvular AF who underwent RFCA for the first time were included in this study. All patients underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) before the procedure. All patients were followed up for one year after RFCA, and AF recurrence was recorded. Speckle-tracking echocardiography was used to measure LA and LAA global longitudinal strain (GLS). LA and LAA mechanical dispersion (MD) were defined as the standard deviation of time to peak strain at each segment standardized by the R-R interval. Logistic regression analysis was used to analyze independent contributors for AF recurrence after RFCA. The prediction efficiency of factors associated with the presence of AF recurrence was evaluated by the receiver operating characteristic (ROC) curve with area under curve (AUC). RESULTS During 1-year follow-up, 45 (28%) patients had recurrence, and 115 (72%) patients had no recurrence. The age, CHA2 DS2 -VASc score, NT-proBNP, LA volume index (LAVI), LA MD, and LAA MD of patients in recurrence group were significantly higher than those in no recurrent group (p < .05). The LAA emptying fraction (LAAEF), LA GLS, and LAA GLS in recurrence group were significantly lower than those in no recurrent group (p < .05). Logistic regression analysis showed that LA and LAA GLS were independent contributors for AF recurrence (p < .05), providing incremental values. The AUCs of LA and LAA GLS in predicting AF recurrence were higher than that of other factors, and the LA GLS+LAA GLS joint model had higher prediction efficiency. CONCLUSION This study demonstrated the LA and LAA GLS were independent contributors for AF recurrence after RFCA and provided incremental values. LA and LAA GLS can be used as the predictor of AF recurrence after RFCA, and they may be beneficial for the risk stratification of AF recurrence.
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Affiliation(s)
- You Yang
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Biaohu Liu
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Wenyan Ji
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jing Ding
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Shanqiang Tao
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Feifei Lian
- Department of Ultrasonic Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Tomaselli M, Badano LP, Cannone V, Radu N, Curti E, Perelli F, Heilbron F, Gavazzoni M, Rella V, Oliverio G, Caravita S, Baratto C, Perego GB, Parati G, Brasca F, Muraru D. Incremental Value of Right Atrial Strain Analysis to Predict Atrial Fibrillation Recurrence After Electrical Cardioversion. J Am Soc Echocardiogr 2023; 36:945-955. [PMID: 37302440 DOI: 10.1016/j.echo.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although the assessment of left atrial (LA) mechanics has been reported to refine atrial fibrillation (AF) risk prediction, it doesn't completely predict AF recurrence. The potential added role of right atrial (RA) function in this setting is unknown. Accordingly, this study sought to evaluate the added value of RA longitudinal reservoir strain (RASr) for the prediction of AF recurrence after electrical cardioversion (ECV). METHODS We retrospectively studied 132 consecutive patients with persistent AF who underwent elective ECV. Complete two-dimensional and speckle-tracking echocardiography analyses of LA and RA size and function were obtained in all patients before ECV. The end point was AF recurrence. RESULTS During a 12-month follow-up, 63 patients (48%) showed AF recurrence. Both LASr and RASr were significantly lower in patients experiencing AF recurrence than in patients with persistent sinus rhythm (LASr, 10% ± 6% vs 13% ± 7%; RASr, 14% ± 10% vs 20% ± 9%, respectively; P < .001 for both). Right atrial longitudinal reservoir strain (area under the curve = 0.77; 95% CI, 0.69-0.84; P < .0001) was more strongly associated with the recurrence of AF after ECV than LASr (area under the curve = 0.69; 95% CI, 0.60-0.77; P < .0001). Kaplan-Meier curves showed that patients with both LASr ≤ 10% and RASr ≤ 15% had a significantly increased risk for AF recurrence (log-rank, P < .001). However, at multivariable Cox regression, RASr (hazard ratio, 3.26; 95% CI, 1.73-6.13; P < .001) was the only parameter independently associated with AF recurrence. Right atrial longitudinal reservoir strain was more strongly associated with the occurrence of AF relapse after ECV than LASr, and LA and RA volumes. CONCLUSION Right atrial longitudinal reservoir strain was independently and more strongly associated than LASr with AF recurrence after elective ECV. This study highlights the importance of assessing the functional remodeling of both the RA and LA in patients with persistent AF.
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Affiliation(s)
- Michele Tomaselli
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Luigi P Badano
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - Vincenzo Cannone
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Noela Radu
- Carol Davila University of Medicine and Pharmacy, Prof. Dr. C. C. Iliescu Institute, Bucharest, Romania
| | - Emanuele Curti
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesco Perelli
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesca Heilbron
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Mara Gavazzoni
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Valeria Rella
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Giorgio Oliverio
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Sergio Caravita
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, Italy
| | - Claudia Baratto
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Giovanni B Perego
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Gianfranco Parati
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesco Brasca
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Denisa Muraru
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Telle Å, Bargellini C, Chahine Y, Del Álamo JC, Akoum N, Boyle PM. Personalized biomechanical insights in atrial fibrillation: opportunities & challenges. Expert Rev Cardiovasc Ther 2023; 21:817-837. [PMID: 37878350 PMCID: PMC10841537 DOI: 10.1080/14779072.2023.2273896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/18/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Atrial fibrillation (AF) is an increasingly prevalent and significant worldwide health problem. Manifested as an irregular atrial electrophysiological activation, it is associated with many serious health complications. AF affects the biomechanical function of the heart as contraction follows the electrical activation, subsequently leading to reduced blood flow. The underlying mechanisms behind AF are not fully understood, but it is known that AF is highly correlated with the presence of atrial fibrosis, and with a manifold increase in risk of stroke. AREAS COVERED In this review, we focus on biomechanical aspects in atrial fibrillation, current and emerging use of clinical images, and personalized computational models. We also discuss how these can be used to provide patient-specific care. EXPERT OPINION Understanding the connection betweenatrial fibrillation and atrial remodeling might lead to valuable understanding of stroke and heart failure pathophysiology. Established and emerging imaging modalities can bring us closer to this understanding, especially with continued advancements in processing accuracy, reproducibility, and clinical relevance of the associated technologies. Computational models of cardiac electromechanics can be used to glean additional insights on the roles of AF and remodeling in heart function.
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Affiliation(s)
- Åshild Telle
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Clarissa Bargellini
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Yaacoub Chahine
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Juan C Del Álamo
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
| | - Nazem Akoum
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Patrick M Boyle
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, USA
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Kiliszek M, Uziębło-Życzkowska B, Krzyżanowski K, Jurek A, Wierzbowski R, Smalc-Stasiak M, Krzesiński P. Value of Left Atrial Strain in Predicting Recurrence after Atrial Fibrillation Ablation. J Clin Med 2023; 12:4034. [PMID: 37373726 DOI: 10.3390/jcm12124034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/27/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
This study tested the relationship between left atrial (LA) function parameters and the results of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Consecutive patients undergoing PVI for the first time between 2019 and 2021 were included. Patients underwent radiofrequency ablation using contact force catheters and an electroanatomical system. Follow-up consisted of ambulatory visits/televisits and 7-day Holter monitoring (at 6 and 12 months after ablation). On the day of ablation, all patients underwent transesophageal and transthoracic echocardiography with LA strain analysis. The primary endpoint was atrial tachyarrhythmia recurrence during the follow-up period. Of 221 patients, 22 did not meet the echocardiographic quality criteria, leaving 199 patients. The median follow-up period was 12 months, and 12 patients were lost to follow-up. Recurrences were observed in 67 patients (35.8%) after a mean of 1.06 procedures per patient. The patients were divided into a sinus rhythm (SR, n = 109) group and an AF (n = 90) group based on their cardiac rhythm at the time of echocardiography. In the SR group, univariable analysis showed that LA reservoir strain, LA appendage emptying velocity (LAAV), and LA volume index predicted AF recurrence, with only LAAV being significant in the multivariable analysis. In AF patients, univariable analysis revealed no LA strain parameters predicting AF recurrence.
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Affiliation(s)
- Marek Kiliszek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Krystian Krzyżanowski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Agnieszka Jurek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Robert Wierzbowski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Magdalena Smalc-Stasiak
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
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Serenelli M, Cantone A, Dal Passo B, Di Ienno L, Fiorio A, Pavasini R, Passarini G, Bertini M, Campo G. Atrial Longitudinal Strain Predicts New-Onset Atrial Fibrillation: A Systematic Review and Meta-Analysis. JACC Cardiovasc Imaging 2023; 16:392-395. [PMID: 36648050 DOI: 10.1016/j.jcmg.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 12/15/2022]
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Li Y, Li Y, Sun L, Ye X, Cai Q, Zhu W, Guo D, Ding X, Wang J, Lv X. Left atrial strain for predicting recurrence in patients with non-valvular atrial fibrillation after catheter ablation: a single-center two-dimensional speckle tracking retrospective study. BMC Cardiovasc Disord 2022; 22:468. [PMID: 36335294 PMCID: PMC9637312 DOI: 10.1186/s12872-022-02916-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
Abstract
Background Although catheter ablation (CA) is an effective treatment for non-valvular atrial fibrillation (AF), a good many of patients still have a recurrence following post-operation. Prediction of AF recurrence by evaluating left atrial (LA) phase function with speckle tracking echocardiography (STE) may be helpful for risk stratification and clinical management for AF patients. Therefore, the current study aimed to assess the prognostic value of LA strains in non-valvular AF patients after CA. Methods A total of 95 non-valvular AF patients (70.5% paroxysmal AF, 56.8% males, mean age 63.2 ± 9.7 years) were included in this retrospective study between October 2019 and August 2020. Transthoracic echocardiography was performed in all the subjects and STE was used to analyze the LA reservoir strain (LASr), LA conduit strain (LAScd) and LA contractile strain (LASct) during different phases before CA. Patients were followed up with until January 2022. The endpoint was AF recurrence. Results Over a median follow-up period of 26.0 months (interquartile range, 24.7–26.7 months), 26 patients experienced recurrence and 69 stayed in sinus rhythm. Compared with no-recurrence group, maximum volume of LA (LAVmax), minimum volume of LA (LAVmin) and LA volume index (LAVI) were increased in the recurrence group, while LAEF, LASr and LASct were worsened (P < 0.05). Multivariable logistic regression analysis revealed that LASct was an independent predictor of AF recurrence (odds ratio, 0.89; 95% confidence interval (CI), 0.82–0.97; P = 0.007) and receiver operating characteristic (ROC) curve analysis showed an area under the curve of LASct<8% was 0.70 (95% CI, 0.59–0.79; P = 0.0008). Conclusions LASct was of independent predictive value of AF recurrence. LA function assessed by STE may contribute to the risk stratification for AF patients and selection of suitable patients for CA.
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Bruns F, Dobrev D. Assessment of atrial function by echocardiography: Can this be used to assess the arrhythmogenic atrial substrate? Int J Cardiol 2022; 362:190-191. [PMID: 35659557 DOI: 10.1016/j.ijcard.2022.05.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Florian Bruns
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, 45147 Essen, Germany; Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Duisburg-Essen, 45147 Essen, Germany
| | - Dobromir Dobrev
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, 45147 Essen, Germany; Department of Molecular Physiology & Biophysics, Baylor College of Medicine, Houston, USA; Montréal Heart Institute, University de Montréal, Montréal, Canada.
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Assessment of Left Atrial Structure and Function by Echocardiography in Atrial Fibrillation. Diagnostics (Basel) 2022; 12:diagnostics12081898. [PMID: 36010248 PMCID: PMC9406407 DOI: 10.3390/diagnostics12081898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. Echocardiography is the imaging technique of first choice to assess LA structure and function due to its better availability, accessibility and safety over cardiac computed tomography and cardiac magnetic resonance. Therefore, the aim of this review is to summarize the recent research progress of evaluating LA size by three-dimensional echocardiography and LA function by speckle tracking echocardiography (STE) in predicting the occurrence and recurrence of AF and determining the risk of stroke in AF. In addition, we summarized the role of traditional echocardiography in detecting AF patients that are at high risk of heart failure or cardiovascular death.
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Tang ZW, Liu JH, Zhang YX, Mo DG. Left atrial strain: A potential target to predict atrial fibrillation. Int J Cardiol 2022; 366:48. [PMID: 35820541 DOI: 10.1016/j.ijcard.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Zhan-Wei Tang
- Department of Cardiology, Liaocheng People(')s Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, PR China
| | - Jia-Hui Liu
- Department of Cardiology, Liaocheng People(')s Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, PR China
| | - Yue-Xin Zhang
- Department of Neurology, Liaocheng People(')s Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, PR China
| | - De-Gang Mo
- Department of Cardiology, Liaocheng People(')s Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, PR China.
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