Ramkumar, S and Pathan, F and Kawakami, H and Ochi, A and Yang, H and Potter, EL and Marwick, TH, Impact of disease stage on the performance of strain markers in the prediction of atrial fibrillation, International Journal of Cardiology pp. 1-9. ISSN 0167-5273 (2020) [Refereed Article]
© 2020 Published by Elsevier B.V.
Methods: We compared a PP cohort (351 community-based participants ≥65 years with ≥1 risk factor for AF) and a SP cohort (453 patients after transient ischemic attack or stroke). LV global longitudinal strain (GLS) and left atrial reservoir strain (LARS) were measured from DICOM images. AF was diagnosed by 12 lead ECG, Holter or by single lead monitor over median follow-up of 22 months (PP) and 35 months (SP). The clinical and echocardiographic characteristics of those with AF were compared to those in sinus rhythm. Nested Cox-regression models assessed for independent and incremental predictive value of LARS and GLS in both cohorts.
Results: AF developed in 42 PP (12%) and 60 SP (13%), and was associated with age, higher CHARGE-AF score, increased LA volume and LV mass (p < 0.05). Patients developing AF had reduced GLS (17 ± 3.5% vs. 20 ± 3%, p < 0.001) and LARS (28 ± 11% vs. 35 ± 8%, p < 0.001). However, the predictive value of both GLS (area under the ROC curve 0.83 vs 0.56, p < 0.001) and LARS (0.83 vs 0.57, p < 0.001) was greater in SP than PP. LARS was independently associated with AF in both cohorts (p < 0.05), but GLS was only independently associated in the SP cohort.
Conclusion: AF risk assessment with LARS is suitable for different risk cohorts, but GLS is more useful in SP.
|Item Type:||Refereed Article|
|Keywords:||atrial fibrillation, left atrium, screening, strain|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Pathan, F (Dr Faraz Pathan)|
|UTAS Author:||Ochi, A (Miss Ayame Ochi)|
|UTAS Author:||Yang, H (Ms Hilda Yang)|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|Deposited By:||Menzies Institute for Medical Research|
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