title: Left atrial longitudinal strain parameters predict postoperative persistent atrial fibrillation following mitral valve surgery: a speckle tracking echocardiography study.
abstract: Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy.
authors.affiliation: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
authors.forename: Ozkan
authors.initials: O
authors.lastname: Candan
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Soe Moe
authors.initials: SM
authors.lastname: Aung
authors.forename: Cem
authors.initials: C
authors.lastname: Dogan
authors.forename: Can Yucel
authors.initials: CY
authors.lastname: Karabay
authors.forename: Cetin
authors.initials: C
authors.lastname: Gecmen
authors.forename: Onur
authors.initials: O
authors.lastname: Omaygenç
authors.forename: Ahmet
authors.initials: A
authors.lastname: Güler
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D019245:Compressive Strength; D004452:Echocardiography / Q000706:statistics & numerical data; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D013314:Stress, Mechanical; D013718:Tensile Strength; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: left atrial longitudinal strain; mitral valve surgery; postoperative atrial fibrillation; speckle tracking echocardiography