title: Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Abnormalities in the left atrial (LA) structure and function may develop in patients with paroxysmal atrial fibrillation (AF). We sought to determine the contribution of LA mechanical function, including LA stiffness, to AF by comparing patients with paroxysmal AF with normal control subjects, and to evaluate whether LA mechanical function and stiffness are related with the structural changes of LA.
  
  
  METHODS
  Sixty-four paroxysmal AF patients (57 ± 13 years, 59% male) were studied, using a speckle tracking echocardiography, and were compared with 34 age-, gender-, and left ventricular (LV) mass-matched controls (53 ± 14 years, 61% male). LA volume indices, expansion index for reservoir function, active emptying fraction for contractile function, mitral annular velocities, and global longitudinal LA strain were measured. The ratio of E/e' to LA strain was used as an index of LA stiffness.
  
  
  RESULTS
  Patients with paroxysmal AF had similar LV volume indices, ejection fraction, and diastolic function, when compared with that of the normal controls. However, paroxysmal AF patients showed increased LA volume indices and decreased LA reservoir function, but similar contractile function. LA stiffness was increased in patients with paroxysmal AF than in the control subjects (0.40 ± 0.25 vs. 0.29 ± 0.10, p = 0.002), and was related with LA volume indices and reservoir function.
  
  
  CONCLUSIONS
  Patients with paroxysmal AF have decreased LA reservoir function and increased stiffness, in comparison with that of the control subjects. LA stiffness was significantly related with LA volume indices and reservoir function. LA stiffness can be used for the assessment of LA function in patients with paroxysmal AF.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sung-Ai
authors.initials: SA
authors.lastname: Kim
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Jae-Hyeong
authors.initials: JH
authors.lastname: Park
authors.forename: Kyoung-Ha
authors.initials: KH
authors.lastname: Park
authors.forename: Seonghoon
authors.initials: S
authors.lastname: Choi
authors.forename: Min-Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Kim
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho