Ramkumar, S and Ochi, A and Kawakami, H and Yang, H and Potter, EL and D'Elia, N and Negishi, T and Negishi, K and Marwick, TH, Echocardiographic risk assessment to guide screening for atrial fibrillation, Journal of the American Society of Echocardiography, 32, (10) pp. 1259-1267. ISSN 0894-7317 (2019) [Refereed Article]
Methods: Asymptomatic participants ≥65 years of age with more than one AF risk factor (N = 445) undergoing echocardiography for risk evaluation were followed over a median of 15 months for incident AF. Left atrial volume index (LAVi), left ventricular (LV) global longitudinal strain (GLS; absolute value), left atrial (LA) strain, and LV mass were measured. During the follow-up period, AF was diagnosed clinically by primary care physicians or by using a single-lead portable electrocardiographic monitoring device (five 60-sec recordings performed by participants over 1 week).
Results: AF was diagnosed in 45 patients (10%; mean age, 70.5 ± 4.2 years; 55% women). AF detection was higher in those with LV hypertrophy, GLS < 16%, LAVi > 34 mL/m2, and LA reservoir strain < 34%. GLS, LAVi, and LA reservoir strain were independently associated with AF (P < .05). Those with AF had reduced GLS, higher LAVi, and higher LV mass (P < .05), but LA strain was similar in both groups (P > .05). GLS and LAVi were the strongest predictors, and cut points of 14.3% for GLS and 39 mL/m2 were associated with increased risk for developing AF. Those with all four risk parameters (LV hypertrophy, GLS < 16%, LA reservoir strain < 34%, and LAVi > 34 mL/m2) had a 60% AF detection rate, compared with 7% without these features (P = .004).
Conclusion: Echocardiography is widely used in patients at risk for AF, and simple LV and LA measurements may be used to enrich the process of AF screening.
|Item Type:||Refereed Article|
|Keywords:||atrial fibrillation, left atrium, screening, 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:||Ochi, A (Miss Ayame Ochi)|
|UTAS Author:||Yang, H (Ms Hilda Yang)|
|UTAS Author:||Negishi, T (Dr Tomoko Negishi)|
|UTAS Author:||Negishi, K (Dr Kazuaki Negishi)|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|Deposited By:||Menzies Institute for Medical Research|
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