title: Atrial Function Assessed by Speckle Tracking Echocardiography Is a Good Predictor of Postoperative Atrial Fibrillation in Elderly Patients.
abstract: OBJECTIVE
  Advanced age is an independent predictor of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass surgery. We evaluated whether left atrial (LA) dysfunction assessed by strain contributes to identifying elderly patients prone to POAF.
  
  
  METHODS
  Case-control study of 70 subjects undergoing coronary artery bypass surgery. Clinical and laboratory characteristics were recorded at baseline and 72 hours after surgery. Echocardiography was performed during the preoperative period; LA dimensions and deformation by strain (systolic wave [LASs]) as well as strain rate (systolic wave [LASRs] and atrial contraction wave [LASRa]) were assessed.
  
  
  RESULTS
  Postoperative atrial fibrillation occurred in 38.5% of patients within the first 72 hours after surgery (28.5% of the younger vs. 48.6% of the older group). Baseline and postoperative inflammatory markers as well as total surgical and aortic clamp time were similar between groups. LA function was markedly impaired in subjects with POAF. Age correlated with LASs, LASRs, and LASRa. These associations remained consistent when subjects 75 years or older were considered separately. Both LASs and LASRa for patients with or without POAF, respectively, were significantly impaired in elderly subjects with POAF. Multivariate analysis provided further evidence that both LASs and age are independent predictors for POAF.
  
  
  CONCLUSIONS
  Age-related changes in atrial function preceding atrial dilation are evident only upon LA strain analysis. LA strain impairment is an independent predictor of POAF irrespective of age and may serve as a surrogate marker for biological processes involved in establishing the substrate for POAF.
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Hugo E
authors.initials: HE
authors.lastname: Verdejo
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.
authors.forename: Elia
authors.initials: E
authors.lastname: Becerra
authors.affiliation: Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquet
authors.affiliation: Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.
authors.forename: Andrea
authors.initials: A
authors.lastname: Del Campo
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.
authors.forename: Lorena
authors.initials: L
authors.lastname: Garcia
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.|Nutrition Institute, Universidad de Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Troncoso
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.
authors.forename: Mario
authors.initials: M
authors.lastname: Chiong
authors.affiliation: Department of Internal Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Marin
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Castro
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Center for Molecular Studies of the Cell, Universidad de Chile, Santiago, Chile.|Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Sergio
authors.initials: S
authors.lastname: Lavandero
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gabrielli
authors.affiliation: Advanced Center for Chronic Diseases, Universidad de Chile & Pontificia Universidad Catolica de Chile, Santiago, Chile.|Division of Cardiovascular Diseases, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Ramón
authors.initials: R
authors.lastname: Corbalán
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018570:Risk Assessment
keywords: aging; atrial fibrillation; atrial function; echocardiography; speckle tracking