loading page

Left atrial strain parameters to predicting elevated left atrial pressure in patients with atrial fibrillation
  • +5
  • Ying Xu,
  • Jiawei Zhou,
  • Bo Su,
  • Yun-juan Sun,
  • Jing Zhou,
  • Yang Liu,
  • BingYuan Zhou,
  • Cao Zou
Ying Xu
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Jiawei Zhou
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Bo Su
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Yun-juan Sun
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Jing Zhou
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Yang Liu
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
BingYuan Zhou
First Affiliated Hospital of Soochow University Department of Cardiology
Author Profile
Cao Zou
First Affiliated Hospital of Soochow University Department of Cardiology

Corresponding Author:nkzc75@suda.edu.cn

Author Profile

Abstract

Objectives: To assess the ability of left atrial(LA) strain parameters to discriminate patients with elevated left atrial pressure(LAP) from patients with atrial fibrillation(AF). Methods and results: A total of 142 patients with non-valvular AF who underwent first catheter ablation(CA) between November 2022 and November 2023 were enrolled in the study. Conventional and speckle-tracking echocardiography(STE)were performed in all patients within 24 hours before CA,and LAP was invasively measured during the ablation procedure. According to mean LAP,the study population was classified into 2 groups of normal LAP(LAP< 15 mmHg, n=101) and elevated LAP(LAP≥15 mmHg, n=41).Compared with the normal LAP group, elevated LAP group showed significantly reduced LA reservoir strain (LASr) [9.14 ( 7.97 -11.80 ) vs 20(13.59-26.96), p < 0.001], and increased LA filling index[9.60 ( 7.15 -12.20 ) vs 3.72 ( 2.17 -5.82 ),p<0.001], LA stiffness index[1.13 ( 0.82-1.46 ) vs 0.47( 0.30 -0.70 ),p<0.001]. LASr, LA filling index and LA stiffness index were independent predictors of elevated LAP after adjusted by the type of AF, EDT, E/e’, mitral E and Peak acceleration rate of mitral E velocity. The receiver-operating characteristic curve (ROC) analysis showed LA strain parameters (area under curve [AUC] 0.794 to 0.819) could provide similar or greater diagnostic accuracy for elevated LAP, as compared to conventional echocardiographic parameters. Furthermore, the novel algorithms built by LASr, LA stiffness index, LA filling index and LA emptying fraction(LAEF), was used to discriminate elevated LAP in AF with good accuracy (AUC 0.880, accuracy of 81.69%, sensitivity of 80.49%, specificity of 82.18%), and much better than 2016 ASE/EACVI algorithms in AF. Conclusion: In patients with AF,LA strain parameters could be useful to predict elevated LAP and non-inferior to conventional echocardiographic parameters. Besides, the novel algorithm built by LA strain parameters combined with conventional parameters would improve the diagnostic efficiency.
09 May 2024Submitted to Echocardiography
29 May 2024Review(s) Completed, Editorial Evaluation Pending
29 May 2024Editorial Decision: Revise Major
10 Jun 20241st Revision Received
10 Jun 2024Submission Checks Completed
10 Jun 2024Assigned to Editor
10 Jun 2024Review(s) Completed, Editorial Evaluation Pending
13 Jun 2024Editorial Decision: Accept