Kawakami, H and Ramkumar, S and Pathan, F and Wright, L and Marwick, TH, Use of echocardiography to stratify the risk of atrial fibrillation: comparison of left atrial and ventricular strain, European Heart Journal - Cardiovascular Imaging, (October) pp. 1-9. ISSN 2047-2404 (2019) [Refereed Article]
Copyright The Author(s) 2019
Methods and Results: We evaluated 531 consecutive patients (median age 67 years, 56% male), with no history of AF who underwent echocardiography after cryptogenic stroke. Standard echocardiographic parameters were measured, and speckle-tracking was used to measure LA (reservoir, pump, and conduit strain) and LV strain (global longitudinal strain, GLS). The baseline clinical and echocardiographic parameters of the patients who developed AF and those who did not were compared. Median 36 months of follow-up, 61 patients (11%) had newly diagnosed AF. LA pump strain and GLS were significantly and independently associated with AF and provided incremental predictive value over clinical and standard echocardiographic parameters. Areas under the receiver-operating curves for GLS (0.841) were comparable to LA pump (0.825) and reservoir (0.851) strain. However, predictive value of both strains was different between patients with and without LA enlargement at the time of transthoracic echocardiography screening. LA strain was more useful than LV strain in patients with normal LA volumes, while LV strain was more useful than LA strain in patients with abnormal LA volumes.
Conclusion: Both LA and LV strain are significantly and independently associated with AF and provide incremental predictive value over clinical and standard echocardiographic parameters. However, priorities of strain assessment are different depends on patients' condition at the time of echocardiography.
|Item Type:||Refereed Article|
|Keywords:||atrial fibrillation, atrial strain, echocardiography, speckle-tracking, ventricular strain|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|UTAS Author:||Pathan, F (Dr Faraz Pathan)|
|Deposited By:||Menzies Institute for Medical Research|
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