Evaluating subclinical left ventricular and left atrial dysfunction in idiopathic atrial fibrillation: A speckle-tracking based strain-analysis

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  • Manouk J.W. van Mourik
  • Dr Linz, Dominik Karl
  • Harm J.A. Verwijs
  • Sebastiaan C.A.M. Bekkers
  • Jerremy Weerts
  • Ulrich Schotten
  • Hanspeter Brunner La Rocca
  • Joost Lumens
  • Harry J.G.M. Crijns
  • Bob Weijs
  • Christian Knackstedt

Objective: A subset of patients with atrial fibrillation (AF) presents without established AF risk factors and normal left ventricular (LV) systolic function, called idiopathic AF (IAF). Traditionally, echocardiography derived LV dimensions and ejection fraction (EF) are used to exclude LV dysfunction in IAF, but their sensitivity is limited. Our objective is to evaluate the presence of subtle alterations in LV function despite normal LVEF in patients with IAF compared to healthy controls, using speckle-tracking echocardiography (STE) based global longitudinal strain (GLS). Methods: Standard transthoracic echocardiography was performed in 80 patients with IAF and 129 healthy controls. Patients with overt cardiac disease as well as known established AF risk factors were excluded. STE analysis was performed to assess GLS of the LV, and left atrial strain (LAS). Results: LVEF was normal and comparable between patients with IAF and healthy controls (63 ± 4% for both groups; p = 0.801). Mean GLS was within normal limits for both groups but statistically significantly more negative in patients with IAF (−20.6 ± 2.5% vs. -19.7 ± 2.5%; p = 0.016), however not when indexed for ventricular cycle length (p = 0.784). No differences in LA volume or non-indexed LAS were seen in patients with IAF compared to healthy controls. Conclusions: In this selected group of IAF patients, STE did not detect any overt LV or LA dysfunction compared to healthy controls. Thus, IAF occurred in these patients not only in the absence of established AF risk factors but also without evidence of ventricular or atrial dysfunction.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume383
Pages (from-to)159-165
Number of pages7
ISSN0167-5273
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s)

    Research areas

  • Echocardiography, Global longitudinal strain, Idiopathic atrial fibrillation, Left ventricular function, Speckle-tracking

ID: 347794818