Abstract 12400: Quantitative Assessment of Left Atrial Mechanics in Patients with Paroxysmal Atrial Fibrillation Using Three-dimensional Speckle Tracking Echocardiography

Abstract

Purpose: Two-dimensional speckle tracking-derived left atrial (LA) strain facilitates a comprehensive evaluation of LA mechanical function. However, it is limited in its ability to provide appropriate quantitative analysis. This study evaluated LA mechanics in patients with paroxysmal atrial fibrillation (PAF) using three-dimensional (3D) speckle tracking strain echocardiography.

Methods: A total of 38 patients with PAF (PAF group: age 61 ± 12 years, 26 males) and 22 normal controls (control group: age 56 ± 19 years, 11 males) were examined. Routine transthoracic echocardiography was performed in all subjects. LA global area tracking strain (LA-GAT) and standard deviation of the time to peak strain in each LA segment (SD-TPS) were measured using 3D speckle tracking strain echocardiography. Measurements in the PAF group were taken during sinus rhythm.

Results: LA volume was significantly larger in the PAF group than in the control group (68.6 ± 16.8 cm³ vs. 50.3 ± 14.5 cm³, p < 0.0001). Other parameters, including left ventricular ejection fraction, E/A ratio, and E/e′ ratio were similar in both groups. Using 3D speckle tracking analysis, we determined that LA-GAT was significantly lower (44.6 ± 17.6 vs. 71.8 ± 26.7, p < 0.0001) and SD-TPS was significantly higher (143.9 ± 69.7 vs. 61.0 ± 39.5, p < 0.0001) in the PAF group than in the control group. Though LA-GAT and SD-TPS were unrelated to LA volume, SD-TPS showed significant correlation with LA-GAT (r = 0.66, p < 0.0001) in the PAF group.

Conclusion: LA mechanical function was quantitatively and precisely assessed by 3D speckle tracking strain echocardiography. In this study, LA dysfunction, LA mechanical asynchrony, and deformation were evident in PAF patients. These results are important while considering the pathogenesis of PAF.