Abstract 2576: Atrial Strain Imaging of Pulmonary Veins in Patients With Atrial Fibrillation
Background: Pulmonary veins (PVs) play an important role in the pathogenesis of the atrial fibrillation (AF). The function of the PV had been evaluated indirectly by assessment of their flow using Doppler methods, but direct evaluation using Doppler tissue imaging (DTI) and strain imaging have not been described. The aim of this study was to evaluate strain profiles of the PV at the left atrial (LA) junction (the target for PV isolation treatment for AF).
Methods: Echocardiograms were acquired in 6 healthy young individuals (30.5 ± 3.9 years, 83% males) and in 10 subjects with history of paroxysmal AF (60.1 ± 9.4 years, 50% males) in sinus rhythm, prior to PV isolation. DTI and strain parameters of left upper (LU) PV and right upper (RU) PV at their insertion into LA were acquired in 4 chamber standard view.
Results: The controls had normal left ventricular (LV) and LA cavity and function on standard echo. Patients with AF had larger LA volumes, 59.5 ml vs 40.9 ml (p<0.05), and reduced LA ejection fraction, 52.3% vs. 68.8% (p=0.003), as well as a delayed early ventricular filling phase, 675.3 ms vs. 571.6 ms (p<0.001). PV strain measurements demonstrated a significant reduced displacement in the RUPV junction adjacent to the basal wall of LA in all 3 active atrial phases (LA contraction, LV contraction, and early LV filling) in AF patients compared with normal controls (see Table⇓). The LUPV strain showed similar patterns during LA contraction and during LV contraction.
Conclusions: Strain imaging is a feasible method for the evaluation of PV function. There are significant differences in strain parameters, indicating abnormal compliance of RUPV and LUPV in patients with AF, as well as measures of LA size and function. Strain should be evaluated as an early parameter identifying latent atrial myopathy in patients potentially prone to AF.