Key result
Each 1 mL/m2 increase in left atrial volume index independently increased the odds of atrial fibrillation by 1.098 (OR 1.098) in adult patients with congenital septal defects.
Why the study?
Morphofunctional changes in left and right atrial myocardial deformation and their association with atrial fibrillation in adult patients with congenital septal defects are not well characterized.
Cohort (n=120)
No
Odds Ratio: 1.098 (95% CI 1.029–1.171)
p-value: p=0.005
In adults with congenital septal defects, left atrial volume index and estimated right ventricular systolic pressure are independent predictors of atrial fibrillation, highlighting the need for comprehensive assessment of both heart chambers.
May aid AF risk stratification in adult septal defects; hypothesis-generating, needs prospective validation before practice change.
Aim. To compare myocardial deformation indicators between the left (LA) and right atria (RA) using speckle tracking echocardiography in adult patients with septal defects and to identify parameters associated with the atrial fibrillation (AF). Materials and methods. A prospective study conducted from 2022 to 2025 included 120 patients with congenital heart disease and left-to-right blood shunting (mean age 51.0±13.1 years). The congenital heart defects in the cohort included atrial septal defect in 82.5% (n=99), partial anomalous pulmonary vein drainage with atrial septal defect in 11.7% (n=14), and partial atrioventricular canal in 5.8% (n=7); in all cases, a significant arteriovenous shunt was observed. Paroxysmal AF was diagnosed in 29.8% of patients. Results. Notable RA dilation was observed with indexed RA volume of 49.9±18 mL/m2, while the indexed LA volume was borderline at 32.6±12.4 mL/m2, showing a significant difference between the two (p0.001). Additionally, deformation parameters during the contraction phase also differed significantly (p0.002). Moderate to strong correlations were established between the volumetric and deformation parameters of both chambers. The independent predictors of AF, identified through multivariate analysis, included the left atrial volume index (LAVI) (odds ratio 1.098, 95% confidence interval 1.029–1.171; p=0.005) and the estimated right ventricular systolic pressure (eRVSP) (odds ratio 1.080, 95% confidence interval 1.004–1.163; p=0.040). Conclusion. Morphofunctional changes associated with septal defects are characteristic of both RA and LA. LAVI and eRVSP are independent predictors of AF development, highlighting the importance of a comprehensive assessment of both the right and left heart chambers.
No takes yet. Share an insight, caveat, or question.
Golukhova et al. (2026) conducted a cohort in Congenital septal defects with left-to-right blood shunting (n=120). Left atrial volume index (LAVI) vs. per 1 mL/m2 increase was evaluated on Atrial fibrillation (AF) (OR 1.098, 95% CI 1.029-1.171, p=0.005). Each 1 mL/m2 increase in left atrial volume index independently increased the odds of atrial fibrillation by 1.098 (OR 1.098) in adult patients with congenital septal defects.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: