Key result
Atrial septal aneurysm linked to ~40% lower global LA strain and increased stiffness vs controls.
Why the study?
Atrial septal aneurysm is a risk factor for arterial embolism, and atrial dysfunction and arrhythmia may contribute to this risk, but left atrial mechanical function and stiffness in ASA patients have not been well characterized.
Does atrial septal aneurysm impair left atrial mechanical function and increase stiffness compared to matched controls?
Case-Control (n=65)
No
Does atrial septal aneurysm impair left atrial mechanical function and increase stiffness compared to matched controls?
Absolute Event Rate: 25.3% vs 42.1%
p-value: p=<0.001
Patients with atrial septal aneurysm exhibit impaired left atrial mechanical function and increased stiffness, which may contribute to their increased risk of atrial arrhythmias and arterial embolism.
Atrial septal aneurysm may signal higher arrhythmia risk via impaired mechanics; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Atrial septal aneurysm (ASA) is a risk factor for arterial embolism. Atrial dysfunction and atrial arrhythmia, such as atrial fibrillation, might represent a mechanism for arterial embolism in such patients. Speckle tracking echocardiography (STE) is a novel and promising tool for detecting early changes in left atrial (LA) myocardial dysfunction. The aim of the study was to evaluate LA mechanical function and stiffness in ASA patients by 2-dimensional STE strain parameters. METHODS: Thirty-four ASA patients (44.2 ± 12.3 years, 15 male) were studied, using a STE, and were compared with 31 age, gender, and left ventricular (LV) mass-matched controls (41.8 ± ± 11.5 years, 14 male). LA volume indices, mitral annular velocities, and global longitudinal LA strain were measured. The ratio of E/e' to LA strain was used as an index of LA stiffness. RESULTS: Patients with ASA showed increased LA volume indices and decreased LA global strain (25.3 ± 5.2 vs. 42.1 ± 8.7, p < 0.001). LA stiffness was increased in patients with ASA compared to the control subjects (0.41 ± 0.15 vs. 0.14 ± 0.05, p < 0.001), and LA strain and stiffness were related with LA volume indices. CONCLUSIONS: Patients with ASA have decreased LA global strain and increased stiffness, in comparison with those of the control subjects. LA strain and stiffness were significantly related with LA volume indices. LA stiffness and strain can be used for the assessment of LA function in patients with ASA.
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Demir et al. (2015) conducted a case-control in Atrial septal aneurysm (n=65). Atrial septal aneurysm vs. Matched controls with normal cardiac structures was evaluated on Global left atrial peak strain (p=<0.001). Patients with atrial septal aneurysm had significantly decreased global left atrial strain (25.3% vs 42.1%) and increased left atrial stiffness (0.41 vs 0.14) compared to matched controls.
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