Key result
Patients with paroxysmal atrial fibrillation had significantly increased ∆-TPLS (52.83 vs 31.33, p<0.05) and decreased ACLS (10.09 vs 13.74, p<0.05) compared to controls.
Why the study?
Does two-dimensional speckle tracking echocardiography detect differences in left atrial function between patients with paroxysmal atrial fibrillation and those in sinus rhythm?
Case-Control (n=63)
Does two-dimensional speckle tracking echocardiography detect differences in left atrial function between patients with paroxysmal atrial fibrillation and those in sinus rhythm?
2D speckle tracking echocardiography can non-invasively detect impaired left atrial function (increased ∆-TPLS and decreased ACLS) in patients with paroxysmal atrial fibrillation even when in sinus rhythm.
Answers are grounded in this paper and cite their sources.
May support speckle tracking for LA assessment in PAF; hypothesis-generating and should not yet change practice.
Introduction To observe the changes of left atrium function in patients with paroxysmal atrial fibrillation (AF) using two-dimensional (2D) speckle tracking echocardiography (STE). Methods The study population consisted of 33 patients with paroxysmal atrial fibrillation and 30 age, sex-matched control subjects in sinus rhythm (SR) who were referred to our echocardiography laboratory. All of the patients were in sinus rhythm when they were checked. Left atrial diameter (LAD), left atrial area (LAA), interventricular septum thickness (IVST); Left ventricular end-diastolic diameter (LVEDD) were measured in 2-dimensional echocardiography imaging. LV ejection fraction was determined. Measured mitral valve A wave velocity time integral (VTI-A) and maximum velocity (VA). LA wall strain in the longitudinal direction obtained using 2DSTE. Measured peak atrial longitudinal strain (PALS) and atrial contraction longitudinal strain (ACLS) in apical 4-chamber view and apical 2- chamber view. Measured time to peak longitudinal strain (TPLS). ∆ was defined as the difference between the TPLS in apical 4-chamber view and apical 2- chamber view. Results There were no significant differences between the 2 groups regarding age (63±12 vs 60±9 years), sex (males 48% vs 60%) and history of hypertension and diabetes mellitus. Compared with control group, ∆-TPLS were significantly increased in AF group (52.83±32.2 vs 31.33±20.2, p<0.05). In Patients with AF, ACLS were significantly decreased than in control group (10.09±3.3 vs 13.74±3.1 p<0.05). The PALS; LAD; LVEDD; IVS; EF; VA; VTI-A and LAA between paroxysmal AF and control group did not show statisticant difference (p>0.05). Conclusions 2DSTE can effectively and easily measure LA ∆-TPLS and ACLS, speckle tracking echocardiography could be a method to non-invasively assess LA function in paroxysmal atrial fibrillation patients.
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A S Khir (1985) conducted a case-control in Paroxysmal atrial fibrillation (n=63). Paroxysmal atrial fibrillation vs. Sinus rhythm (controls) was evaluated on ∆-TPLS (difference between time to peak longitudinal strain in apical 4-chamber and 2-chamber views) (p=<0.05). Patients with paroxysmal atrial fibrillation had significantly increased ∆-TPLS (52.83 vs 31.33, p<0.05) and decreased ACLS (10.09 vs 13.74, p<0.05) compared to controls.
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