Left atrial strain: A memory of the severity of atrial myocardial stress in atrial fibrillation - 17/02/24
Résumé |
What's new |
• | Left atrial (LA) reservoir strain could be a memory of initial atrial myocardial stress in atrial fibrillation (AF). |
• | LA reservoir strain can be predicted using a combination of clinical, biological, metabolomic, and echocardiographic admission variables. |
• | Improvement in characterization of atrial cardiomyopathy in AF is essential in clinical practice because this could be one of the major causes of stroke and heart failure. We identified clinical, biological, metabolomic, and echocardiographic variables associated with atrial cardiomyopathy. The multivariable approach appears to be superior to predict alteration of LA strain. |
• | Early identification of these factors should be useful to facilitate early management of atrial cardiomyopathy in AF. LA strain could well be an integrator of the multiple determinants of atrial myocardial stress. |
Abstract |
Background |
Left atrial (LA) strain is a simple marker of LA function. The aim of the study was to evaluate the determinants of atrial cardiomyopathy in AF.
Methods |
In this pilot study, we prospectively evaluated clinical, biological, metabolomic and echocardiographic parameters for 85 consecutive patients hospitalized for atrial fibrillation (AF) with restoration of sinus rhythm at 6 months. Eighty-one patients with an analysable LA strain at 6 months were divided into groups according to median reservoir strain:<23.3% (n=40) versus≥23.3% (n=41).
Results |
Compared to patients with the highest LA strain, patients with lowest LA strain had multiple differences at admission: clinical (older age; more frequent history of AF; more patterns of persistent AF); biological (higher fasting blood glucose levels, glycated haemoglobin, high-sensitivity C-reactive protein, and urea; lower glomerular filtration rate); metabolomic (higher levels of kynurenine, kynurenine/tryptophan, and urea/creatinine; lower levels of arginine and methionine/methionine sulfoxide); and echocardiographic (higher two-dimensional end-systolic LA volume [LAV] indexes; higher three-dimensional end-systolic and end-diastolic LAV and right atrial volume indexes; lower LA and right atrial emptying fractions and three-dimensional right ventricular ejection fraction) (all P<0.05). Area under the receiver operating characteristic curve to predict LA strain alteration at 6 months was highest for a combined score including clinical, biological, metabolomic and echocardiographic variables at admission (area under the receiver operating characteristic curve 0.871; P<0.0001).
Conclusions |
LA reservoir strain could be a memory of initial atrial myocardial stress in AF. It can be predicted using a combination of clinical, biological, metabolomic and echocardiographic admission variables.
Le texte complet de cet article est disponible en PDF.Keywords : Atrial fibrillation, Metabolomics, Three-dimensional echocardiography, Strain imaging, Atrial cardiomyopathy
Abbreviations : 2D, 3D, 4D, AF, ED, ES, FASTRHAC, LA, LAV, LVEF, LVV, RAV
Plan
| ☆ | X: @lsoulatdufour. X: Left atrial reservoir strain could be a memory of initial atrial myocardial stress in atrial fibrillation and could be predicted using a combination of clinical, biological, metabolomic, and echocardiographic admission variables. #AtrialStrainAF. |
Vol 117 - N° 2
P. 134-142 - février 2024 Retour au numéro
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