Abstract 13984: Left Atrial Strain and Stiffness in Patients With Atrial Fibrillation Pre- And Post-Cardioversion: A Speckle Echocardiographic Study
Introduction: Currently, the influence of underlying heart rhythm on left atrial (LA) strain measures is not well established. The purpose of this prospective investigation was to (a) study left atrial mechanics [peak systolic strain (LASr) and stiffness (LASt)] before and after cardioversion in patients with atrial fibrillation (AF), and (b) to determine the influence of underlying rhythm on strain measures.
Methods: We recruited 34 subjects who had persistent AF and who underwent elective electrical cardioversion. We performed baseline (in AF) and immediate post-cardioversion (in normal sinus rhythm) echocardiographic measurements. We also measured LASr and LASt (E/ E' ratio/ LASr) in 41 age-matched participants without AF. An offline analysis using speckle echocardiography was performed using GE Healthcare software.
Results: LASr was significantly lower (pre-CV 12.19 %; post-CV 15.9 %; control 35.75 %, p value < 0.0001), and LASt higher (pre-CV 1.25; post-CV 1.12; control 0.23, p value < 0.0001), in participants with AF as compared with controls, irrespective of the presence of AF. Although LASr improved after CV (p value = 0.008), LASt didn't change significantly in patients with AF (Figure 1). In regression models, pre- and post-CV LASr were significantly lower in participants with AF than in controls, even after adjustment for age, sex, heart rate and LA volume index.
Conclusion: We found that LASr was lower and LASt was higher in participants with AF than in controls irrespective of the presence of AF at the time of strain measurement (Figure 1). LASr increased immediately after cardioversion, possibly due to improved mechanical efficiency; however LASt remained relatively unchanged, as it may be less dependent on LA mechanics. Our findings suggest that these strain measures might represent novel, non-invasive, rhythm-independent traits capable of assessing atrial remodeling in patients with, or at risk for, AF.
- © 2011 by American Heart Association, Inc.