title: Atrial fibrillation per se was a major determinant of global left ventricular longitudinal systolic strain.
abstract: Atrial fibrillation (AF) may cause systolic abnormality via inadequate diastolic filling and tachycardia-induced cardiomyopathy. Global longitudinal strain (GLS) is a very sensitive method for detecting subtle left ventricular systolic dysfunction. Hence, this study aimed to evaluate whether AF patients had a more impaired GLS, AF was a major determinant of GLS, and determine the major correlates of GLS in AF patients.The study included 137 patients with persistent AF and left ventricular ejection fraction (LVEF) above 50% and 137 non-AF patients matched according to age, gender, and LVEF. Comprehensive echocardiography with GLS assessment was performed for all cases.Compared with non-AF patients, AF patients had a more impaired GLS, a larger left atrial volume index, higher transmitral E wave velocity (E), and early diastolic mitral velocity (Ea) (all P < 0.001) but comparable E/Ea. After adjustment for baseline and echocardiographic characteristics, the presence of AF remained significantly associated with impaired GLS (β = 0.533, P < 0.001). In addition, multivariate analysis of AF patients indicated that faster heart rates and decreased E, Ea, and LVEF were associated with more impaired GLS.This study demonstrated that AF patients had a more impaired GLS than non-AF patients, although LVEF was comparable between the 2 groups. AF was a major determinant of GLS even after adjustment for relevant clinical and echocardiographic parameters.
authors.affiliation: aDivision of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital bDepartment of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital cFaculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hung-Hao
authors.initials: HH
authors.lastname: Lee
authors.forename: Meng-Kuang
authors.initials: MK
authors.lastname: Lee
authors.forename: Wen-Hsien
authors.initials: WH
authors.lastname: Lee
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Chun-Yuan
authors.initials: CY
authors.lastname: Chu
authors.forename: Chee-Siong
authors.initials: CS
authors.lastname: Lee
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology*; D005260:Female; D006334:Heart Function Tests / Q000379:methods; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013599:Systole; D016277:Ventricular Function, Left