Key result
Reduced LA reservoir strain linked to ~33% lower LA compliance in AF patients.
Why the study?
Left atrial reservoir strain (LASr) is a novel marker of LA function, and its association with invasive and non-invasive markers of atrial cardiomyopathy in AF patients required evaluation.
Does reduced left atrial reservoir strain (<20%) identify advanced invasive and non-invasive markers of atrial cardiomyopathy in patients with symptomatic atrial fibrillation and preserved left ventricular ejection fraction?
Observational (n=91)
Does reduced left atrial reservoir strain (<20%) identify advanced invasive and non-invasive markers of atrial cardiomyopathy in patients with symptomatic atrial fibrillation and preserved left ventricular ejection fraction?
Absolute Event Rate: 0.28% vs 0.42%
p-value: p=<0.001
Reduced left atrial reservoir strain (<20%) on resting transthoracic echocardiography is significantly associated with invasive and non-invasive markers of hemodynamic, mechanical, and electrical atrial dysfunction, serving as a non-invasive marker of advanced atrial cardiomyopathy in symptomatic AF patients.
BACKGROUND: Left atrial reservoir strain (LASr) is a novel marker of left atrial (LA) function. We hypothesized that LASr can be used to identify atrial cardiomyopathy in patients with atrial fibrillation (AF). OBJECTIVE: To evaluate the association between LASr and invasive and non-invasive markers of atrial cardiomyopathy in AF patients. METHODS: We prospectively recruited patients with symptomatic paroxysmal or persistent AF and preserved left ventricular (LV) ejection fraction scheduled for catheter ablation. Resting transthoracic echocardiography was performed focusing on the left atrium (LA). Participants were dichotomised into two groups: reduced LASr (<20%) and preserved LASr (≥20%). Markers of LA cardiomyopathy were compared between these two groups; invasive markers included mean LA pressure, mean LA voltage and LA compliance whilst non-invasive markers included LA volumes and NT-pro BNP. RESULTS: A total of 91 patients were enrolled. Patients with reduced LASr (n=31) were older (69.4±8.9 vs 59.6±11.3 years, p<0.001), and more commonly female (45.2 vs 18.3%, p=0.007). Reduced LASr correlated with lower LA compliance (0.28±0.16 vs 0.42±0.25mm/mmHg, p<0.001), higher LA pressure (14.8±3.81 vs 13.1±4.46mmHg, p=0.031), and lower LA voltage (1.65±1.35 vs 3.12±1.57mV, p<0.01). On non-invasive assessment, reduced LASr was also associated with higher NT-proBNP levels (479 [200-1073] vs 121 [58-256] pg/ml p<0.001) and larger LA volumes (38.5±11.5 vs 32.6±7.7 mL/m2, p<0.001). CONCLUSION: In patients with symptomatic AF, reduced LASr is associated with a more advanced atrial cardiomyopathy involving hemodynamic, mechanical and electrical atrial dyfsfunction. LASr may therefore provide a useful non-invasive marker of atrial cardiomyopathy in AF.
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Abbas et al. (2026) conducted an observational in Symptomatic paroxysmal or persistent atrial fibrillation (n=91). Reduced left atrial reservoir strain (LASr <20%) vs. Preserved left atrial reservoir strain (LASr ≥20%) was evaluated on Invasive and non-invasive markers of atrial cardiomyopathy (including mean LA compliance, LA pressure, LA voltage, LA volumes, and NT-proBNP) (p=<0.001). Reduced left atrial reservoir strain (<20%) was associated with lower LA compliance (0.28 vs 0.42 mm/mmHg, p<0.001) and lower LA voltage (1.65 vs 3.12 mV, p<0.01) in AF patients.
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