How to detect atrial fibrosis.

Figures

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  Figure 1.. Two-dimensional transthoracic echocardiography with speckle tracking imaging.

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  Figure 2.. Transthoracic echocardiography in the four-chamber view showing global left atrial longitudinal strain in a normal subject. In sinus rhythm, a positive peak of strain corresponding to the reservoir phase (yellow arrow) and a negative one related to atrial contraction or pump function (pink arrow) are identified.

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  Figure 3.. Transthoracic echocardiography in the four-chamber view showing global left atrial longitudinal strain in a normal subject. The strain rate during diastole of the left ventricle identifies two negative peaks; the first corresponds to early passive filling (red arrow) and the second to the pump function of the left atrium (green arrow).

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  Figure 4.. Transthoracic echocardiography in the four-chamber view showing global left atrial longitudinal strain rate. In the presence of atrial fibrillation, one of the two negative peaks of the strain rate curve disappears (blue arrow).

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  Figure 5.. Transthoracic echocardiography in the four-chamber view showing global left atrial longitudinal strain in a patient with permanent atrial fibrillation. The reduction of atrial compliance causes a deterioration of the reservoir function, with a reduction of strain (orange arrow).

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  Figure 6.. Correlation between global peak atrial longitudinal strain and left atrial fibrosis.

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  Figure 7.. Typical contrast-enhanced image obtained by cardiac magnetic resonance imaging in a patient. Hyper-enhancement is present (arrow) in coronary-perfusion territory-left anterior descending coronary artery, with a range of transmural involvement.

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  Figure 8.. Ischemic cardiomyopathy and atrial fibrillation. Left atrial dilation with late contrast uptake, visible as thin areas along the left atrial wall, in relation to atrial fibrosis (arrow).

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  Figure 9.. The black triangle represents the degree of atrial fibrosis according to the Utah classification. The left triangle represents the degree of atrial fibrosis according to the Utah classification. The middle triangle represents atrial longitudinal strain and the right one represents the frequency of atrial fibrillation.