Left atrial reservoir strain as a surrogate marker for atrial fibrillation burden in patients with non-valvular atrial fibrillation.

IF 2.5 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of the Formosan Medical Association Pub Date : 2025-02-24 DOI:10.1016/j.jfma.2025.02.024

An-Li Yu, Yen-Bin Liu, Lian-Yu Lin, Hui-Chun Huang, Li-Ting Ho, Kuan-Chih Huang, Ling-Ping Lai, Wen-Jone Chen, Yi-Lwung Ho, Lung-Chun Lin, Chih-Chieh Yu

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Abstract

Background: To evaluate the correlation between atrial fibrillation (AF) burden and two-dimensional LA (left atrium) longitudinal reservoir strain (LARS) to explore the potential clinical utility of this novel parameter in patients with AF.

Methods: This cross-sectional study was conducted at the cardiac electrophysiology clinic of a tertiary centre by consecutively enrolling patients with non-valvular AF. The AF burden was evaluated using 14-day patch-based electrocardiography and defined as the percentage of time spent in AF during a 14-day monitoring period. High and low AF burdens were defined based on the median 14-day AF burden. Echocardiographic measurements, including the longitudinal strain of the LA, were performed in all patients.

Results: Among 267 patients, LARS was successfully performed in 221 (age 63 ± 11 years, male 71%, paroxysmal AF 71%). After adjusting for age, diabetes mellitus, congestive heart failure, estimated glomerular filtration rate, low-density lipoprotein level, left ventricular ejection fraction, LA dimension, and LA volume in multivariable linear regression analysis, low LARS remained a significant predictor of AF burden in addition to N-terminal pro-B-type natriuretic peptide and sex. Receiver operating curve analysis demonstrated that the best cut-off value for LARS to predict high AF burden (above median 10.49%) was 21.5%, with 75% sensitivity and 83% specificity.

Conclusions: LARS is associated with the AF burden in patients with AF. Further studies are needed to determine the role of routine LARS measurements in such patients.

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非瓣膜性房颤患者左房储层应变作为房颤负荷的替代指标。

背景：评价心房颤动（AF）负荷与二维左心房纵向储层应变（LARS）的相关性，探讨该新参数在房颤患者中的潜在临床应用价值。这项横断研究是在一家三级中心的心脏电生理诊所进行的，通过连续招募非瓣膜性房颤患者。使用14天贴片心电图评估房颤负担，并将其定义为14天监测期间房颤时间的百分比。根据平均14天房颤负担来定义高和低房颤负担。超声心动图测量，包括左心室纵向应变，在所有患者中进行。结果：267例患者中，221例（年龄63±11岁，男性71%，阵发性房颤71%）成功行LARS。在多变量线性回归分析中调整了年龄、糖尿病、充血性心力衰竭、肾小球滤过率、低密度脂蛋白水平、左室射血分数、左室血凝素维度和左室血凝素体积等因素后，除了n端前b型利钠肽和性别外，低左室血凝素维度仍然是AF负担的重要预测因子。受试者工作曲线分析显示，LARS预测高心房颤负荷（高于中位数10.49%）的最佳临界值为21.5%，敏感性为75%，特异性为83%。结论：房颤患者的LARS与房颤负担相关，需要进一步的研究来确定常规LARS测量在此类患者中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Formosan Medical Association 医学-医学：内科

CiteScore

6.50

自引率

6.20%

发文量

381

审稿时长

57 days

期刊介绍： Journal of the Formosan Medical Association (JFMA), published continuously since 1902, is an open access international general medical journal of the Formosan Medical Association based in Taipei, Taiwan. It is indexed in Current Contents/ Clinical Medicine, Medline, ciSearch, CAB Abstracts, Embase, SIIC Data Bases, Research Alert, BIOSIS, Biological Abstracts, Scopus and ScienceDirect. As a general medical journal, research related to clinical practice and research in all fields of medicine and related disciplines are considered for publication. Article types considered include perspectives, reviews, original papers, case reports, brief communications, correspondence and letters to the editor.