TY - JOUR
T1 - Evaluating subclinical left ventricular and left atrial dysfunction in idiopathic atrial fibrillation
T2 - A speckle-tracking based strain-analysis
AU - van Mourik, Manouk J W
AU - Linz, Dominik
AU - Verwijs, Harm J A
AU - Bekkers, Sebastiaan C A M
AU - Weerts, Jerremy
AU - Schotten, Ulrich
AU - Rocca, Hanspeter Brunner-La
AU - Lumens, Joost
AU - Crijns, Harry J G M
AU - Weijs, Bob
AU - Knackstedt, Christian
N1 - Funding Information:
JL received research funding from the Dutch Heart Foundation (grant 2015T082 ) and the Netherlands Organisation for Scientific Research (grant 016.176.340 ).
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/7/15
Y1 - 2023/7/15
N2 - OBJECTIVE: A subset of patients with atrial fibrillation (AF) presents without established AF risk factors and normal left ventricular (LV) systolic function, called idiopathic AF (IAF). Traditionally, echocardiography derived LV dimensions and ejection fraction (EF) are used to exclude LV dysfunction in IAF, but their sensitivity is limited. Our objective is to evaluate the presence of subtle alterations in LV function despite normal LVEF in patients with IAF compared to healthy controls, using speckle-tracking echocardiography (STE) based global longitudinal strain (GLS).METHODS: Standard transthoracic echocardiography was performed in 80 patients with IAF and 129 healthy controls. Patients with overt cardiac disease as well as known established AF risk factors were excluded. STE analysis was performed to assess GLS of the LV, and left atrial strain (LAS).RESULTS: LVEF was normal and comparable between patients with IAF and healthy controls (63 ± 4% for both groups; p = 0.801). Mean GLS was within normal limits for both groups but statistically significantly more negative in patients with IAF (-20.6 ± 2.5% vs. -19.7 ± 2.5%; p = 0.016), however not when indexed for ventricular cycle length (p = 0.784). No differences in LA volume or non-indexed LAS were seen in patients with IAF compared to healthy controls.CONCLUSIONS: In this selected group of IAF patients, STE did not detect any overt LV or LA dysfunction compared to healthy controls. Thus, IAF occurred in these patients not only in the absence of established AF risk factors but also without evidence of ventricular or atrial dysfunction.
AB - OBJECTIVE: A subset of patients with atrial fibrillation (AF) presents without established AF risk factors and normal left ventricular (LV) systolic function, called idiopathic AF (IAF). Traditionally, echocardiography derived LV dimensions and ejection fraction (EF) are used to exclude LV dysfunction in IAF, but their sensitivity is limited. Our objective is to evaluate the presence of subtle alterations in LV function despite normal LVEF in patients with IAF compared to healthy controls, using speckle-tracking echocardiography (STE) based global longitudinal strain (GLS).METHODS: Standard transthoracic echocardiography was performed in 80 patients with IAF and 129 healthy controls. Patients with overt cardiac disease as well as known established AF risk factors were excluded. STE analysis was performed to assess GLS of the LV, and left atrial strain (LAS).RESULTS: LVEF was normal and comparable between patients with IAF and healthy controls (63 ± 4% for both groups; p = 0.801). Mean GLS was within normal limits for both groups but statistically significantly more negative in patients with IAF (-20.6 ± 2.5% vs. -19.7 ± 2.5%; p = 0.016), however not when indexed for ventricular cycle length (p = 0.784). No differences in LA volume or non-indexed LAS were seen in patients with IAF compared to healthy controls.CONCLUSIONS: In this selected group of IAF patients, STE did not detect any overt LV or LA dysfunction compared to healthy controls. Thus, IAF occurred in these patients not only in the absence of established AF risk factors but also without evidence of ventricular or atrial dysfunction.
KW - Echocardiography
KW - Global longitudinal strain
KW - Idiopathic atrial fibrillation
KW - Left ventricular function
KW - Speckle-tracking
KW - Speckle -tracking
U2 - 10.1016/j.ijcard.2023.04.024
DO - 10.1016/j.ijcard.2023.04.024
M3 - Article
C2 - 37088325
SN - 0167-5273
VL - 383
SP - 159
EP - 165
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -