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Original article
Published online: 2021-09-20
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Correlations between left atrial strain and left atrial pressures values in patients undergoing atrial fibrillation ablation

Beata Uziębło-Życzkowska1, Paweł Krzesiński1, Agnieszka Jurek1, Krystian Krzyżanowski1, Marek Kiliszek1
DOI: 10.33963/KP.a2021.0113
·
Pubmed: 34599496
Affiliations
  1. Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland

open access

Online first
Original article
Published online: 2021-09-20

Abstract

Aims: We aimed to investigate the correlations between left atrial strain (LAS) assessed by speckle tracking echocardiography and directlymeasured left atrial pressures (LAP) values and estimate the features of patients with lower LAS values.
Methods: A prospective, observational study was performed on patients with atrial fibrillation (AF) undergoing ablation. Detailed transthoracic echocardiography with the speckle tracking method was used to estimate the LAS reservoir (LASr) and direct measurements of LAP during ablation in all patients.
Results: A total of 172 patients were included (98 with sinus rhythm [SR] and 74 with AF). The patients with lower LASr (first tercile) compared to those with higher (third tercile), were older, more often female, presented with a larger left atrium (LA) (per the LA area and volume index) and had more impaired left ventricular (LV) diastolic function parameters (e’, E/e’). The correlation analysis of the echocardiographic parameters with the LAP revealed the most significant correlations in the SR group, where the E/e’ ratio, LASr and LAS contraction (LASct) values were all associated with LAP. The cut-off value of LASr estimating high elevated mean LAP (≥15 mm Hg) was 21.88, (area under curve [AUC] 0.81; 95% confidence interval [CI], 0.72–0.90; P <0.0001) for SR group and 11.25 (AUC 0.66; 95% CI, 0.53–0.80; P = 0.016) for AF group.
Conclusions: AF patients with lower LASr are older, more often female, have a larger LA and have more impaired LV diastolic function. Low LASr and LASct and high E/e’ ratio values are associated with higher LAP in AF patients with SR.

Abstract

Aims: We aimed to investigate the correlations between left atrial strain (LAS) assessed by speckle tracking echocardiography and directlymeasured left atrial pressures (LAP) values and estimate the features of patients with lower LAS values.
Methods: A prospective, observational study was performed on patients with atrial fibrillation (AF) undergoing ablation. Detailed transthoracic echocardiography with the speckle tracking method was used to estimate the LAS reservoir (LASr) and direct measurements of LAP during ablation in all patients.
Results: A total of 172 patients were included (98 with sinus rhythm [SR] and 74 with AF). The patients with lower LASr (first tercile) compared to those with higher (third tercile), were older, more often female, presented with a larger left atrium (LA) (per the LA area and volume index) and had more impaired left ventricular (LV) diastolic function parameters (e’, E/e’). The correlation analysis of the echocardiographic parameters with the LAP revealed the most significant correlations in the SR group, where the E/e’ ratio, LASr and LAS contraction (LASct) values were all associated with LAP. The cut-off value of LASr estimating high elevated mean LAP (≥15 mm Hg) was 21.88, (area under curve [AUC] 0.81; 95% confidence interval [CI], 0.72–0.90; P <0.0001) for SR group and 11.25 (AUC 0.66; 95% CI, 0.53–0.80; P = 0.016) for AF group.
Conclusions: AF patients with lower LASr are older, more often female, have a larger LA and have more impaired LV diastolic function. Low LASr and LASct and high E/e’ ratio values are associated with higher LAP in AF patients with SR.

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Keywords

atrial fibrillation, left atrial pressure, left atrial strain, speckle tracking echocardiography

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Title

Correlations between left atrial strain and left atrial pressures values in patients undergoing atrial fibrillation ablation

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-09-20

DOI

10.33963/KP.a2021.0113

Pubmed

34599496

Keywords

atrial fibrillation
left atrial pressure
left atrial strain
speckle tracking echocardiography

Authors

Beata Uziębło-Życzkowska
Paweł Krzesiński
Agnieszka Jurek
Krystian Krzyżanowski
Marek Kiliszek

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