title: Atrial Strain and Strain Rate: A Novel Method for the Evaluation of Atrial Stunning.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common arrhythmia seen in adults. Atrial stunning is defined as the temporary mechanical dysfunction of the atrial appendage developing after AF has returned to sinus rhythm (SR).
  
  
  OBJECTIVE
  We aimed to evaluate atrial contractile functions by strain and strain rate in patients with AF, following pharmacological and electrical cardioversion and to compare it with conventional methods.
  
  
  METHODS
  This study included 41 patients with persistent AF and 35 age-matched control cases with SR. All the AF patients included in the study had transthoracic and transesophageal echocardiography performed before and after. Septum (SEPsSR), left atrium (LAsSR) and right atrium peak systolic strain rate (RAsSR) were defined as the maximum negative value during atrial contraction and septum (SEPε), left atrium (LAε) and right atrium peak systolic strain (RAε) was defined as the percentage of change. Parameters of two groups were compared.
  
  
  RESULTS
  In the AF group, 1st hour and 24th hour LAε, RAε, SEPε, LAsSR, RAsSR, SEPsSR found to be significantly lower than in the control group (LAε: 2.61%±0.13, 3.06%±0.19 vs 6.45%±0.27, p<0.0001; RAε: 4.03%±0.38, 4.50%±0.47 vs 10.12%±0.64, p<0.0001; SEPε: 3.0%±0.22, 3.19%±0.15 vs 6.23%±0.49, p<0.0001; LAsSR: 0.61±0.04s-1, 0.75±0.04s- 1 vs 1.35±0.04s-1, p<0.0001; RAsSR: 1.13±0.06s-1, 1.23±0.07s-1 vs 2.10±0.08s- 1, p<0.0001; SEPsSR: 0.76±0.04s- 1, 0.78±0.04s- 1 vs 1.42±0.06 s- 1, p<0.0001).
  
  
  CONCLUSIONS
  Atrial strain and strain rate parameters are superior to conventional echocardiographic parameters for the evaluation of atrial stunning in AF cases where SR has been achieved.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Bahcesehir University, Istanbul, Turquia.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkan
authors.affiliation: Department of Cardiology, Ortadogu Hospital, Adana, Turquia.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Binici
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Center, Bursa, Turquia.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioglu
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Center, Bursa, Turquia.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ari
authors.affiliation: Department of Cardiology, Medicalpark Hospital, Bursa, Turquia.
authors.forename: Tahsin
authors.initials: T
authors.lastname: Bozat
mesh_terms: D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016275:Atrial Function / Q000502:physiology*; D004452:Echocardiography; D004554:Electric Countershock / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D013997:Time Factors