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July 29, 2024EchocardiographyOpen Access

Echocardiographic estimation of left ventricular filling pressure in atrial fibrillation using left atrial strain: Ready for practical use?

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Why the study?

Accurate echocardiographic assessment of LV filling pressure remains challenging in patients with AF, prompting evaluation of whether LA strain parameters can reliably estimate it.

Do left atrial strain parameters accurately predict elevated left ventricular filling pressure in patients with atrial fibrillation?

Population

142 atrial fibrillation patients undergoing catheter ablation

Comparison

Left atrial strain parameters measured by… vs Invasively measured mean LA pressure via trans…

Design

Editorial

Authors

HIHiroyuki Iwano

Discussion

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Overview

May guide echocardiographic assessment in AF-HF overlap; hypothesis-generating and requires prospective validation.

Structured PICO

Do left atrial strain parameters accurately predict elevated left ventricular filling pressure in patients with atrial fibrillation?

P
Population
142 atrial fibrillation patients (mostly non-heart failure) undergoing catheter ablation (based on the discussed Xu et al. study)
I
Intervention
Left atrial strain parameters (LA reservoir strain, LA filling index, LA stiffness index) measured by echocardiography
C
Comparator
Invasively measured mean LA pressure via trans atrial-septal approach
O
Outcome
Prediction of elevated LA pressure (≥15 mmHg)surrogate

Left atrial strain parameters show promise for noninvasive estimation of left ventricular filling pressure in atrial fibrillation, though practical challenges like beat-to-beat variability and rhythm-specific cut-offs remain.

Limitations

  • LA strain dramatically reduces in AF rhythm requiring different cut-offs
  • LA stunning after AF termination affects measurements
  • Beat-to-beat variability in AF affects accuracy of combined indices

Cite This Study

Hiroyuki Iwano (2024) studied this question.

synapsesocial.com/papers/6a7052b9ac440176ef28fc7ahttps://doi.org/10.1111/echo.15899
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