title: Strain echocardiographic assessment of left atrial function predicts recurrence of atrial fibrillation.
abstract: OBJECTIVE
  We evaluated if a dispersed left atrial (LA) contraction pattern was related to atrial fibrillation (AF) in patients with normal left ventricular (LV) function, and normal or mildly enlarged left atrium.
  
  
  RESULTS
  We included 61 patients with paroxysmal AF (PAF). Of these, 30 had not while 31 had recurrence of AF after radiofrequency ablation (RFA). Twenty healthy individuals were included for comparison. Echocardiography was performed in patients in sinus rhythm the day before RFA. LA volume was calculated. Peak negative longitudinal strain was assessed in 18 LA segments during atrial systole. Contraction duration in 18 LA segments was measured as the time from peak of the P wave on electrocardiogram to maximum myocardial shortening in each segment. The standard deviation of contraction durations was defined as LA mechanical dispersion (LA MD). LA size was rather preserved in patients with PAF (LA volume 25 ± 10 mL/m(2)). LA MD was more pronounced in patients with recurrence of AF after RFA compared with those without recurrence and controls (38 ± 14 ms vs. 30 ± 12 ms vs. 16 ± 8 ms, both P < 0.001). LA MD was a predictor of PAF [OR 7.84 (95%CI 2.15-28.7), P < 0.01, per 10 ms increase] adjusted for age, LA volume, e', and LA function. LA function by strain was reduced in both patients with and without recurrent AF after RFA compared with controls (-14 ± 4% vs. -16 ± 3% vs. -19 ± 2%, both P < 0.05).
  
  
  CONCLUSIONS
  LA MD was pronounced, and LA deformation was reduced in patients with PAF with apparently normal LV structure and function, and normal or mildly enlarged LA. LA MD may be useful as a predictor of AF recurrence after RFA.
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway University of Oslo, Oslo, Norway.
authors.forename: Sebastian I
authors.initials: SI
authors.lastname: Sarvari
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway University of Oslo, Oslo, Norway.
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Haugaa
authors.affiliation: Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway University of Oslo, Oslo, Norway.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Stokke
authors.affiliation: University of Oslo, Oslo, Norway.
authors.forename: Hamza Z
authors.initials: HZ
authors.lastname: Ansari
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Ida S
authors.initials: IS
authors.lastname: Leren
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway.
authors.forename: Finn
authors.initials: F
authors.lastname: Hegbom
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway University of Oslo, Oslo, Norway.
authors.forename: Otto A
authors.initials: OA
authors.lastname: Smiseth
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway University of Oslo, Oslo, Norway thor.edvardsen@medisin.uio.no.
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D016279:Atrial Function, Left / Q000502:physiology*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Atrial fibrillation; Dispersion; Echocardiography; Prediction; Strain