Left atrial strain assessed by speckle tracking imaging is related to new-onset atrial fibrillation after coronary artery bypass grafting.
BACKGROUND
Left atrial (LA) dysfunction was recently proposed as an important factor in the development of postoperative atrial fibrillation (POAF). LA strain analysis by 2-dimensional (2D) speckle tracking imaging is emerging as a new tool to evaluate LA function. We aimed to evaluate the correlation of LA dysfunction assessed by 2D speckle tracking imaging with the occurrence of POAF after coronary artery bypass grafting (CABG).


METHODS
In this study, 53 patients (mean age 66 ± 9 years) undergoing elective isolated CABG were enrolled. Conventional transthoracic echocardiography and 2D speckle tracking strain analysis were performed before surgery. POAF was detected with continuous electrocardiography monitoring throughout hospitalization (mean duration 17 ± 10 days).


RESULTS
POAF occurred in 13 of 53 patients (24%). Patients with POAF were significantly older than patients with normal sinus rhythm after surgery (71 ± 5 vs 64 ± 10 years, P = 0.026). Compared with patients with normal sinus rhythm, patients with POAF had a significantly larger LA volume index (32.6 ± 5.1 vs 27.3 ± 7.2 mL/m(2), P = 0.018), lower value of LA global strain (25.4 ± 10.4 vs 36.8 ± 7.6%, P = 0.001), and strain rate (1.2 ± 0.6 vs 1.6 ± 0.8 seconds, P = 0.024). By multivariate logistic regression analysis, only LA global strain (odds ratio, 1.12; 95% confidence interval, 1.00-1.24; P = 0.040) was an independent predictor of POAF after CABG.


CONCLUSIONS
Preoperative LA global strain measured by 2D speckle tracking strain analysis is associated with the development of POAF after CABG.
Division of Cardiology, Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
Ae-Young
AY
Her
Jong-Youn
JY
Kim
Yong Hoon
YH
Kim
Eui-Young
EY
Choi
Pil-Ki
PK
Min
Young Won
YW
Yoon
Byoung-Kwon
BK
Lee
Bum-Kee
BK
Hong
Se-Joong
SJ
Rim
Hyuck Moon
HM
Kwon
D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D016279:Atrial Function, Left; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D056910:Republic of Korea / Q000453:epidemiology