https://doi.org/10.1007/s00392-024-02526-y
1Universitätsklinikum Jena Kardiologie Jena, Deutschland
Methods: This study includes patients with persistent AF who underwent LA catheter ablation without prior treatment. All subjects underwent measurement of reservoir (LASr), conduit (LAScd) and contraction (LASct) LA strain using two-dimensional speckle tracking echocardiography (2D-STE) and cardiac CT. A 3D reconstruction of the LA from the CT was done using EnSite Verismo (Abbott, USA). The LA volume obtained at the end-systole included LA appendage reconstruction and excluded the pulmonary veins. LAVI was calculated by dividing LA volume by body surface area.
Results: The study included 36 patients (mean age 69 yrs [49 to 80 yrs], 27 male, mean LV-EF 56% [40 to 78%]).
We found the following LA strain measurement: mean LASr 21% [6 to 52%], mean LAScd -12% [-32 to -0,25%] and mean LASct -9% [-32 to -1%]. Mean LAVI: 82 ml/m² [38 to 127 ml/m²].
There is a statistically significant negative correlation between LASr (p = 0.002, r = -0.503) and a statistically positive correlation between LASct (p = 0.003, r = 0.482) compared to the LA volume, whereas there is no statistically significant correlation between LAScd and the LA volume (p = 0.088, r = 0.288).
Discussion: LA strain in patients with persistent AF as an expression of functional remodeling is reduced compared to normal values in literature. Correlation of LA strain and LAVI are statistically significant for LASr as well as LASct. The correlation between LAScd and LAVI did not reach statistical significance but shows a trend towards a positive correlation. Whether early treatment of AF could prevent further fibrotic remodeling with reducing LA volume and improving LA strain needs further research.