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Published in: The International Journal of Cardiovascular Imaging 7/2016

01-07-2016 | Original Paper

Decreased left atrial strain parameters are correlated with prolonged total atrial conduction time in lone atrial fibrillation

Authors: Chunyan Guo, Jiexin Liu, Shumei Zhao, Yixing Teng, Luhua Shen

Published in: The International Journal of Cardiovascular Imaging | Issue 7/2016

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Abstract

To investigate left atrium (LA) strain properties of patients with lone atrial fibrillation (LAF) and to assess relationships between LA strain parameters and total atrial conduction time measured with tissue Doppler imaging (PA-TDI). The study population consisted of 53 patients with LAF. The control group was comprised of 50 normal volunteers. Conventional echocardiography indices were measured. Mitral annular velocities and PA-TDI were assessed with TDI. Two-dimensional speckle-tracking echocardiography (2D-STE) was used to assess LA segmental strain and strain rate. Compared with the control group, PA-TDI was significantly prolonged and LA myocardial Ss, SRs, Sa, and SRa were significantly decreased in the LAF group (all P < 0.001). In the control group, LA myocardial Ss (γ = −0.486, P < 0.01), SRs (γ = −0.436, P < 0.01), and Sa (γ = −0.360, P < 0.05) were correlated negatively with PA-TDI. LA myocardial SRa (γ = 0.377, P < 0.01) was correlated positively with PA-TDI. In the LAF group, LA myocardial Ss (γ = −0.429, P < 0.01), SRs (γ = −0.468, P < 0.01), and Sa (γ = −0.380, P < 0.05) were also correlated negatively, and SRa (γ = 0.390, P < 0.01) was correlated positively, with PA-TDI. Multivariate logistic regression identified PA-TDI as the only predictor of AF onset (OR 1.39; 95 % CI 1.02–1.54; P < 0.01). LA strain parameters were decreased and PA-TDI was prolonged in patients with LAF. Structural remodeling of the LA, assessed by 2D-STE, was correlated with electrical remodeling, determined by PA-TDI. Prolonged PA-TDI was independently associated with AF onset.
Literature
1.
go back to reference Artis NJ, Oxborough DL, Williams G, Pepper CB, Tan LB (2008) Two-dimensional strain imaging: a new echocardiographic advance with research and clinical applications. Int J Cardiol 123:240–248CrossRefPubMed Artis NJ, Oxborough DL, Williams G, Pepper CB, Tan LB (2008) Two-dimensional strain imaging: a new echocardiographic advance with research and clinical applications. Int J Cardiol 123:240–248CrossRefPubMed
2.
go back to reference Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, Rosen BD, Lima JA, Torp H, Ihlen H, Smiseth OA (2005) New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 112:3149–3156CrossRefPubMed Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, Rosen BD, Lima JA, Torp H, Ihlen H, Smiseth OA (2005) New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 112:3149–3156CrossRefPubMed
3.
go back to reference Vieira MJ, Teixeira R, Goncalves L, Gersh BJ (2014) Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr 27:463–478CrossRefPubMed Vieira MJ, Teixeira R, Goncalves L, Gersh BJ (2014) Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr 27:463–478CrossRefPubMed
4.
go back to reference Tsai WC, Lee CH, Lin CC, Liu YW, Huang YY, Li WT, Chen JY, Lin LJ (2009) Association of left atrial strain and strain rate assessed by speckle tracking echocardiography with paroxysmal atrial fibrillation. Echocardiography 26:1188–1194CrossRefPubMed Tsai WC, Lee CH, Lin CC, Liu YW, Huang YY, Li WT, Chen JY, Lin LJ (2009) Association of left atrial strain and strain rate assessed by speckle tracking echocardiography with paroxysmal atrial fibrillation. Echocardiography 26:1188–1194CrossRefPubMed
5.
go back to reference Kuppahally SS, Akoum N, Burgon NS, Badger TJ, Kholmovski EG, Vijayakumar S, Rao SN, Blauer J, Fish EN, Dibella EV, Macleod RS, McGann C, Litwin SE, Marrouche NF (2010) Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI. Circ Cardiovasc Imaging 3:231–239CrossRefPubMed Kuppahally SS, Akoum N, Burgon NS, Badger TJ, Kholmovski EG, Vijayakumar S, Rao SN, Blauer J, Fish EN, Dibella EV, Macleod RS, McGann C, Litwin SE, Marrouche NF (2010) Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI. Circ Cardiovasc Imaging 3:231–239CrossRefPubMed
6.
go back to reference Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 57:e101–e198CrossRefPubMed Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 57:e101–e198CrossRefPubMed
8.
go back to reference Roshanali F, Mandegar MH, Yousefnia MA, Rayatzadeh H, Alaeddini F, Amouzadeh F (2007) Prediction of atrial fibrillation via atrial electromechanical interval after coronary artery bypass grafting. Circulation 116:2012–2017CrossRefPubMed Roshanali F, Mandegar MH, Yousefnia MA, Rayatzadeh H, Alaeddini F, Amouzadeh F (2007) Prediction of atrial fibrillation via atrial electromechanical interval after coronary artery bypass grafting. Circulation 116:2012–2017CrossRefPubMed
9.
go back to reference Cui QQ, Zhang W, Wang H, Sun X, Wang R, Yang HY, Meng XQ, Zhang Y, Wang H (2008) Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 31:74–78CrossRefPubMed Cui QQ, Zhang W, Wang H, Sun X, Wang R, Yang HY, Meng XQ, Zhang Y, Wang H (2008) Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 31:74–78CrossRefPubMed
10.
go back to reference Merckx KL, De Vos CB, Palmans A, Habets J, Cheriex EC, Crijns HJ, Tieleman RG (2005) Atrial activation time determined by transthoracic Doppler tissue imaging can be used as an estimate of the total duration of atrial electrical activation. J Am Soc Echocardiogr 18:940–944CrossRefPubMed Merckx KL, De Vos CB, Palmans A, Habets J, Cheriex EC, Crijns HJ, Tieleman RG (2005) Atrial activation time determined by transthoracic Doppler tissue imaging can be used as an estimate of the total duration of atrial electrical activation. J Am Soc Echocardiogr 18:940–944CrossRefPubMed
11.
go back to reference De Vos CB, Weijs B, Crijns HJ, Cheriex EC, Palmans A, Habets J, Prins MH, Pisters R, Nieuwlaat R, Tieleman RG (2009) Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation. Heart 95:835–840CrossRefPubMed De Vos CB, Weijs B, Crijns HJ, Cheriex EC, Palmans A, Habets J, Prins MH, Pisters R, Nieuwlaat R, Tieleman RG (2009) Atrial tissue Doppler imaging for prediction of new-onset atrial fibrillation. Heart 95:835–840CrossRefPubMed
12.
go back to reference Antoni ML, Bertini M, Atary JZ, Delgado V, ten Brinke EA, Boersma E, Holman ER, van der Wall EE, Schalij MJ, Bax JJ, van de Veire NR (2010) Predictive value of total atrial conduction time estimated with tissue Doppler imaging for the development of new-onset atrial fibrillation after acute myocardial infarction. Am J Cardiol 106:198–203CrossRefPubMed Antoni ML, Bertini M, Atary JZ, Delgado V, ten Brinke EA, Boersma E, Holman ER, van der Wall EE, Schalij MJ, Bax JJ, van de Veire NR (2010) Predictive value of total atrial conduction time estimated with tissue Doppler imaging for the development of new-onset atrial fibrillation after acute myocardial infarction. Am J Cardiol 106:198–203CrossRefPubMed
13.
go back to reference den Uijl DW, Gawrysiak M, Tops LF, Trines SA, Zeppenfeld K, Schalij MJ, Bax JJ, Delgado V (2011) Prognostic value of total atrial conduction time estimated with tissue Doppler imaging to predict the recurrence of atrial fibrillation after radiofrequency catheter ablation. Europace 13:1533–1540CrossRefPubMed den Uijl DW, Gawrysiak M, Tops LF, Trines SA, Zeppenfeld K, Schalij MJ, Bax JJ, Delgado V (2011) Prognostic value of total atrial conduction time estimated with tissue Doppler imaging to predict the recurrence of atrial fibrillation after radiofrequency catheter ablation. Europace 13:1533–1540CrossRefPubMed
14.
go back to reference Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463CrossRefPubMed Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18:1440–1463CrossRefPubMed
15.
go back to reference Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA (2002) Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15:167–184CrossRefPubMed Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA (2002) Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15:167–184CrossRefPubMed
16.
go back to reference Yu CM, Sanderson JE, Marwick TH, Oh JK (2007) Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol 49:1903–1914CrossRefPubMed Yu CM, Sanderson JE, Marwick TH, Oh JK (2007) Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol 49:1903–1914CrossRefPubMed
17.
go back to reference Sun JP, Yang Y, Guo R, Wang D, Lee AP, Wang XY, Lam YY, Fang F, Yang XS, Yu CM (2013) Left atrial regional phasic strain, strain rate and velocity by speckle-tracking echocardiography: normal values and effects of aging in a large group of normal subjects. Int J Cardiol 168:3473–3479CrossRefPubMed Sun JP, Yang Y, Guo R, Wang D, Lee AP, Wang XY, Lam YY, Fang F, Yang XS, Yu CM (2013) Left atrial regional phasic strain, strain rate and velocity by speckle-tracking echocardiography: normal values and effects of aging in a large group of normal subjects. Int J Cardiol 168:3473–3479CrossRefPubMed
18.
go back to reference Li Y, Li WM, Gong YT, Li BX, Liu W, Han W, Dong D, Sheng L, Xue JY, Zhang L, Chu S, Yang BF (2007) The effects of cilazapril and valsartan on the mRNA and protein expressions of atrial calpains and atrial structural remodeling in atrial fibrillation dogs. Basic Res Cardiol 102:245–256CrossRefPubMed Li Y, Li WM, Gong YT, Li BX, Liu W, Han W, Dong D, Sheng L, Xue JY, Zhang L, Chu S, Yang BF (2007) The effects of cilazapril and valsartan on the mRNA and protein expressions of atrial calpains and atrial structural remodeling in atrial fibrillation dogs. Basic Res Cardiol 102:245–256CrossRefPubMed
19.
go back to reference Di Salvo G, Caso P, Lo Piccolo R, Fusco A, Martiniello AR, Russo MG, D’Onofrio A, Severino S, Calabro P, Pacileo G, Mininni N, Calabro R (2005) Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study. Circulation 112:387–395CrossRefPubMed Di Salvo G, Caso P, Lo Piccolo R, Fusco A, Martiniello AR, Russo MG, D’Onofrio A, Severino S, Calabro P, Pacileo G, Mininni N, Calabro R (2005) Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study. Circulation 112:387–395CrossRefPubMed
20.
go back to reference Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP (2009) Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr 22:299–305CrossRefPubMed Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP (2009) Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr 22:299–305CrossRefPubMed
21.
go back to reference Schotten U, Ausma J, Stellbrink C, Sabatschus I, Vogel M, Frechen D, Schoendube F, Hanrath P, Allessie MA (2001) Cellular mechanisms of depressed atrial contractility in patients with chronic atrial fibrillation. Circulation 103:691–698CrossRefPubMed Schotten U, Ausma J, Stellbrink C, Sabatschus I, Vogel M, Frechen D, Schoendube F, Hanrath P, Allessie MA (2001) Cellular mechanisms of depressed atrial contractility in patients with chronic atrial fibrillation. Circulation 103:691–698CrossRefPubMed
22.
go back to reference Boixel C, Fontaine V, Rucker-Martin C, Milliez P, Louedec L, Michel JB, Jacob MP, Hatem SN (2003) Fibrosis of the left atria during progression of heart failure is associated with increased matrix metalloproteinases in the rat. J Am Coll Cardiol 42:336–344CrossRefPubMed Boixel C, Fontaine V, Rucker-Martin C, Milliez P, Louedec L, Michel JB, Jacob MP, Hatem SN (2003) Fibrosis of the left atria during progression of heart failure is associated with increased matrix metalloproteinases in the rat. J Am Coll Cardiol 42:336–344CrossRefPubMed
23.
go back to reference Weijs B, de Vos CB, Limantoro I, Cheriex EC, Tieleman RG, Crijns HJ (2012) The presence of an atrial electromechanical delay in idiopathic atrial fibrillation as determined by tissue Doppler imaging. Int J Cardiol 156:121–122CrossRefPubMed Weijs B, de Vos CB, Limantoro I, Cheriex EC, Tieleman RG, Crijns HJ (2012) The presence of an atrial electromechanical delay in idiopathic atrial fibrillation as determined by tissue Doppler imaging. Int J Cardiol 156:121–122CrossRefPubMed
24.
go back to reference Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS (2006) Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol 47:2357–2363CrossRefPubMed Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS (2006) Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol 47:2357–2363CrossRefPubMed
Metadata
Title
Decreased left atrial strain parameters are correlated with prolonged total atrial conduction time in lone atrial fibrillation
Authors
Chunyan Guo
Jiexin Liu
Shumei Zhao
Yixing Teng
Luhua Shen
Publication date
01-07-2016
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 7/2016
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-0875-3

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