Assessment of left atrial mechanical function and synchrony in paroxysmal atrial fibrillation with two‐dimensional speckle tracking echocardiography

Abstract

Background The aim of this study was to investigate left atrial ( LA ) function and synchrony in paroxysmal atrial fibrillation ( PAF ) patients using two‐dimensional speckle tracking echocardiography ( STE ). Methods Forty‐five PAF patients and 30 healthy controls were enrolled. LA peak ventricular systolic longitudinal strain ( LA S ‐S ) and strain rate ( LA SR ‐S ) and left atrial longitudinal strain ( LA S ‐A ) and strain rate ( LA SR ‐A ) during late diastole were determined using STE , and the standard deviation of the time to peak ( TPSD ) of the regional strains was calculated to quantify LA dyssynchrony. TPSD during ventricular systole and late diastole were named SD s and SD a, respectively. Results Left atrial peak longitudinal strain during ventricular systole ( LA S ‐S ) (29.34±8.57 vs 36.73±6.13), LA SR ‐S (1.27±0.311 vs 1.57±0.25), LA S ‐A (13.11±4.91 vs 17.86±3.57), and LA SR ‐A (−1.51±0.58 vs −1.90±0.30) were reduced in the PAF group compared with the controls ( P <.05 for all). SD s (8.11±3.00% vs 4.67±1.48%) and SD a (5.57±2.26% vs 3.11±1.13%) were greater in PAF patients than in the controls ( P <.05 for both). Furthermore, PAF patients with normal LA sizes exhibited lower LA S ‐S ( P <.05), LA SR ‐S ( P <.05), LA S ‐A ( P <.05), and LA SR ‐A ( P <.05) values and increased SD s ( P <.05) and SD a ( P <.05) values compared with the controls. Multivariate regression confirmed that SD s and SD a were powerful parameters for differentiating PAF patients from controls ( SD s: sensitivity, 83%; specificity, 72%; SD a: sensitivity, 81%; specificity, 76%). Conclusions Left atrial ( LA ) dysfunction and dyssynchrony in PAF patients can be detected with STE even in the absence of LA enlargement. STE ‐derived SD s and SD a were powerful parameters for identifying PAF patients.