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Global Left Atrial Longitudinal Strain Using 3-Beat Method Improves Risk Prediction of Stroke Over Conventional Echocardiography in Atrial Fibrillation
- Source :
- Circulation. Cardiovascular imaging. 13(8)
- Publication Year :
- 2020
-
Abstract
- Background: Atrial fibrillation (AF) is associated with a risk of ischemic stroke, and functional myocardial imaging has offered novel insights on its pathophysiology and prognosis, but its use in AF-related stroke remains limited. We aimed to evaluate the feasibility of left atrial (LA) deformations and its prognostic values of ischemic stroke in a large-scale AF population. Methods: Peak atrial longitudinal strain (LA strain), left ventricular strain (global longitudinal strain), LA strain rate (LA SR) at reservoir (LA longitudinal systolic strain rate), and early diastolic conduit (LA longitudinal early diastolic strain rate) phases were analyzed using 2-dimensional speckle tracking echocardiography. Consecutive 3-beat averaged values of strain and SR were used. The clinical end point was ischemic stroke. Results: Among 1457 AF participants, the mean LA strain, LA longitudinal systolic strain rate, and LA longitudinal early diastolic strain rate values were 12.9±4.8%, 0.80±0.28 s − 1 , and −1.17±0.46 s − 1 , respectively. There were strong positive linear relationships of 3-beat average with index-beat analysis (R=0.94, 0.94, and 0.94 for LA strain, LA longitudinal systolic strain rate, and LA longitudinal early diastolic strain rate, respectively; all P 2 DS 2 -VASc scoring ( C statistics, 0.78–0.81; P =0.006) for ischemic stroke. Overall, the prognostic performances of LA deformations were attenuated after adding global longitudinal strains in models. Conclusions: LA deformations by the 3-beat method are feasible and reproducible during AF. LA strain provided additional prognostic implication over clinical information and conventional echocardiographic measures for ischemic stroke in the AF population but not incremental to global longitudinal strains.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Longitudinal strain
Taiwan
Beat (acoustics)
030204 cardiovascular system & hematology
Risk Assessment
Ventricular Function, Left
03 medical and health sciences
0302 clinical medicine
Left atrial
Heart Rate
Predictive Value of Tests
Risk Factors
Internal medicine
Atrial Fibrillation
Medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Heart Atria
Aged
Ischemic Stroke
Aged, 80 and over
business.industry
Incidence
Reproducibility of Results
Atrial fibrillation
Middle Aged
medicine.disease
Myocardial imaging
Prognosis
Echocardiography
Ischemic stroke
Cardiology
Feasibility Studies
Atrial Function, Left
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19420080
- Volume :
- 13
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Circulation. Cardiovascular imaging
- Accession number :
- edsair.doi.dedup.....34c5a13b49745d1ccf69bd6900732128