Right atrial myocardial deformation by two-dimensional speckle tracking echocardiography predicts recurrence in paroxysmal atrial fibrillation

J Echocardiogr. 2017 Dec;15(4):166-175. doi: 10.1007/s12574-017-0341-9. Epub 2017 Jun 21.

Abstract

Background: Atrial fibrillation (AF) is a bi-atrial disease yet little attention has been given to right heart function in AF. We propose that the assessment of right atrial (RA) and right ventricular function (RV) using two-dimensional speckle tracking echocardiography (2D-STE) could be valuable in predicting AF recurrence in patients with paroxysmal AF (PAF).

Methods: Thirty patients with PAF were prospectively recruited from a dedicated AF clinic. Right atrial size, volume, and area and RV dimensions were analyzed along with RA and RV strain derived from 2D-STE at baseline and at 3 and 12 months.

Results: Higher RA booster strain independently predicted sinus rhythm (SR) maintenance for up to 1 year (P = 0.001). RV strain was impaired in patients with recurrent AF compared to those in SR (P < 0.05) but did not predict AF recurrence. Two-dimensional STE for RA and RV function was simple to perform with excellent reproducibility (adjusted R 2 0.92-0.99).

Conclusions: Two-dimensional STE is useful and highly reproducible in assessing right heart function in AF patients. RA booster strain function was predictive of sinus rhythm maintenance for up to 1 year.

Keywords: Atrial fibrillation; Right atrial strain; Right ventricular strain; Two-dimensional speckle tracking echocardiography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnostic imaging*
  • Atrial Fibrillation / physiopathology
  • Echocardiography
  • Echocardiography, Doppler, Color
  • Female
  • Heart / diagnostic imaging
  • Heart Atria / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Myocardium
  • Prospective Studies
  • Recurrence
  • Reproducibility of Results
  • Ventricular Function, Right / physiology*