What question did this study set out to answer?

This research aims to assess the association between impaired left atrial strain and new-onset atrial fibrillation, as well as adverse clinical outcomes.

March 28, 2026Open Access

Impaired Left Atrial Strain is Associated with New-onset Atrial Fibrillation and Adverse Clinical Outcomes in Primary Care Patients

Key Points

This research aims to assess the association between impaired left atrial strain and new-onset atrial fibrillation, as well as adverse clinical outcomes.
Case-control study design

Structured PICO

Does impaired left atrial strain predict new-onset atrial fibrillation and subsequent adverse clinical outcomes in primary care patients?

Population

432 patients in a nested case-control analysis (216 with new-onset AF, 216 age- and sex-matched controls) and 127 patients in a longitudinal follow-up cohort with new-onset AF, drawn from a primary care cohort (Mass General Brigham system). Case-control cohort: mean age 66, 63.9% male. Follow-up cohort: mean age 68.2, 70% male.

Intervention

Impaired Left Atrial Strain (PALS, PACS, LACS) measured by speckle-tracking echocardiography prior to AF onset

Comparator

Preserved Left Atrial Strain (above median) or matched controls without AF

Outcome

New-onset atrial fibrillation (case-control component) and a composite of all-cause mortality, stroke, myocardial infarction, or heart failure hospitalization (longitudinal component)composite

Impaired left atrial strain, particularly peak atrial longitudinal strain (PALS), is an independent predictor of both new-onset atrial fibrillation and subsequent adverse cardiovascular outcomes in primary care patients.

Abstract

Atrial fibrillation diagnosis5-year follow-up period 216 with AF 216 age and sex matched controls Case-control study Is LA strain associated with new-onset atrial fibrillation?127 patients with new-onset AF and complete follow-up data LA strain capture Is LA strain associated with heart failure hospitalization, stroke, myocardial infarction, all-cause mortality in new-onset AF patients?Follow-up Component Case-control Component Impaired Left Atrial Strain is Associated with New-onset Atrial Fibrillation and Adverse Clinical Outcomes in Primary Care Patients Two -part study within a longitudinal, primary care cohort:Conclusion: In a primary care cohort, impaired LA strain was associated with both new-onset AF and adverse clinical outcomes after AF diagnosis, independent of traditional risk factors and LA size.These findings support the potential role of LA strain for AF risk stratification and subsequent clinical outcomes.

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