Jo-Nan Liao1,2, Tze-Fan Chao1,2, Jen-Yuan Kuo3,4,5,6, Kuo-Tzu Sung3,4,5,6, Jui-Peng Tsai3,4,5,6, Chi-In Lo3,4,5,6, Yau-Huei Lai3,4,5,6, Cheng-Huang Su3,4,5,6, Chung-Lieh Hung7,3,4,5,6, Hung-I Yeh3,4,5,6. 1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (J.-N.L., T.-F.C.). 2. Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (J.-N.L., T.-F.C.). 3. Department of Medicine, MacKay Medical College, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). 4. Medical Research, Mackay Memorial Hospital, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). 5. Division of Cardiology, Departments of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). 6. Mackay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). 7. Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan (C.-L.H.).
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<0.001). Multivariate Cox regression models incorporating conventional echocardiography parameters demonstrated LA strain and SRs to be independent prognosticators of ischemic stroke during a median follow-up of 37.6 months. Utilization of LA strain further provided incremental value over CHA2DS2-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.
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 AFparticipants, 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<0.001). Multivariate Cox regression models incorporating conventional echocardiography parameters demonstrated LA strain and SRs to be independent prognosticators of ischemic stroke during a median follow-up of 37.6 months. Utilization of LA strain further provided incremental value over CHA2DS2-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.
Authors: Martin Eichenlaub; Bjoern Mueller-Edenborn; Jan Minners; Nikolaus Jander; Martin Allgeier; Heiko Lehrmann; Simon Schoechlin; Juergen Allgeier; Dietmar Trenk; Franz-Josef Neumann; Thomas Arentz; Amir Jadidi Journal: Front Physiol Date: 2021-08-05 Impact factor: 4.566
Authors: Taiyuan Huang; Schurr Patrick; Louisa Katharina Mayer; Björn Müller-Edenborn; Martin Eichenlaub; Martin Allgeier; Jürgen Allgeier; Heiko Lehrmann; Christoph Ahlgrim; Marius Bohnen; Simon Schoechlin; Dietmar Trenk; Nikolaus Jander; Franz Josef Neumann; Thomas Arentz; Amir Jadidi Journal: J Clin Med Date: 2022-02-28 Impact factor: 4.241