Key result
Lower left atrial reservoir strain linked to ~35% lower odds of AF progression.
Why the study?
Left atrial and left ventricular strain characterize left ventricular diastolic dysfunction and atrial remodeling, but their association with clinical atrial fibrillation progression required assessment.
Does baseline echocardiographic strain imaging predict clinical AF progression in low-risk individuals?
Does baseline echocardiographic strain imaging predict clinical AF progression in low-risk individuals?
Left atrial reservoir strain (LASr) measured by echocardiography may serve as a marker for predicting the clinical progression of atrial fibrillation, though its independent predictive value requires further validation.
May flag lower AF progression risk in low-risk patients; leaves open independent value after adjustment.
Left atrial (LA) and left ventricular (LV) strain are sensitive parameters characterizing left ventricular diastolic dysfunction and atrial remodeling. We aimed to assess the association of LA and LV strain and clinical AF progression in two pooled European prospective clinical cohorts. Individuals were examined at baseline, with LV global longitudinal strain (GLS), LA reservoir strain (LASr), LA conduit strain (LAScd) and LA contraction strain (LASct) measured by speckle-tracking analysis in transthoracic echocardiography. AF progression was defined as a change from paroxysmal to persistent or persistent to permanent AF. Binary logistic regression was performed to assess the association of baseline strain parameters with AF progression. Of 316 individuals, 29 (9.2%) had AF progression over a median follow-up of 12 months. Restricted cubic spline modelling suggested non-linear associations between GLS and LASr with AF progression. For LASr only the unadjusted spline model reached statistical significance (p = 0.0498), whereas the adjusted spline model did not (p = 0.074). For GLS, the spline fit indicated a U-shaped curve with a slight trend towards non-linearity (p = 0.072 unadjusted; p = 0.13 adjusted). In unadjusted logistic regression, LASr was significantly associated with AF progression (odds ratio (OR) per standard deviation 0.65, 95% CI 0.42–0.99; p = 0.047). Our data suggest a potential non-linear association for GLS and LASr as a marker of diastolic function with higher predicted probability of AF progression at lower strain values. However, the test for non-linearity did not reach statistical significance after adjustment.
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Ohlrogge et al. (2026) studied this question. Lower left atrial reservoir strain (LASr) was significantly associated with 35% lower odds of atrial fibrillation progression over 12 months (OR 0.65, p=0.047).
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