Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep;20(3):140-5.
doi: 10.4250/jcu.2012.20.3.140. Epub 2012 Sep 21.

Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation

Yeonyee E Yoon  1 , Hyun-Jin Kim, Sung-Ai Kim, Seong Hwan Kim, Jae-Hyeong Park, Kyoung-Ha Park, Seonghoon Choi, Min-Kyu Kim, Hyun-Sook Kim, Goo-Yeong Cho
Affiliations

Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation

Yeonyee E Yoon et al. J Cardiovasc Ultrasound. 2012 Sep.

Abstract

Background: Abnormalities in the left atrial (LA) structure and function may develop in patients with paroxysmal atrial fibrillation (AF). We sought to determine the contribution of LA mechanical function, including LA stiffness, to AF by comparing patients with paroxysmal AF with normal control subjects, and to evaluate whether LA mechanical function and stiffness are related with the structural changes of LA.

Methods: Sixty-four paroxysmal AF patients (57 ± 13 years, 59% male) were studied, using a speckle tracking echocardiography, and were compared with 34 age-, gender-, and left ventricular (LV) mass-matched controls (53 ± 14 years, 61% male). LA volume indices, expansion index for reservoir function, active emptying fraction for contractile function, mitral annular velocities, and global longitudinal LA strain were measured. The ratio of E/e' to LA strain was used as an index of LA stiffness.

Results: Patients with paroxysmal AF had similar LV volume indices, ejection fraction, and diastolic function, when compared with that of the normal controls. However, paroxysmal AF patients showed increased LA volume indices and decreased LA reservoir function, but similar contractile function. LA stiffness was increased in patients with paroxysmal AF than in the control subjects (0.40 ± 0.25 vs. 0.29 ± 0.10, p = 0.002), and was related with LA volume indices and reservoir function.

Conclusion: Patients with paroxysmal AF have decreased LA reservoir function and increased stiffness, in comparison with that of the control subjects. LA stiffness was significantly related with LA volume indices and reservoir function. LA stiffness can be used for the assessment of LA function in patients with paroxysmal AF.

Keywords: Atrial fibrillation; Left atrial function; Left atrial stiffness.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Correlation of left atrial stiffness and minimal (A), pre-A (B), and maximal (C) left atrial volume indices. The numbers in parenthesis indicate the p-values of corresponding coefficients. LA: left atrial, LAVI: left atrial volume indices, PCC: Pearson's correlation coefficient, SCC: Spearman's rank correlation coefficient.
Fig. 2
Fig. 2
Correlation of left atrial stiffness and left atrial expansion index (A), active emptying fraction (B), kinetic energy (C), and ejection force (D). The numbers in parenthesis indicate the p-values of corresponding coefficients. LA: left atrial, PCC: Pearson's correlation coefficient, SCC: Spearman's rank correlation coefficient.
See this image and copyright information in PMC

References

    1. Vidaillet H, Granada JF, Chyou PH, Maassen K, Ortiz M, Pulido JN, Sharma P, Smith PN, Hayes J. A population-based study of mortality among patients with atrial fibrillation or flutter. Am J Med. 2002;113:365–370. - PubMed
    1. Stewart S, Hart CL, Hole DJ, McMurray JJ. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med. 2002;113:359–364. - PubMed
    1. 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. 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. 2010;3:231–239. - PubMed
    1. Dittrich HC, Pearce LA, Asinger RW, McBride R, Webel R, Zabalgoitia M, Pennock GD, Safford RE, Rothbart RM, Halperin JL, Hart RG. Left atrial diameter in nonvalvular atrial fibrillation: an echocardiographic study. Stroke Prevention in Atrial Fibrillation Investigators. Am Heart J. 1999;137:494–499. - PubMed
    1. Parkash R, Green MS, Kerr CR, Connolly SJ, Klein GJ, Sheldon R, Talajic M, Dorian P, Humphries KH Canadian Registry of Atrial Fibrillation. The association of left atrial size and occurrence of atrial fibrillation: a prospective cohort study from the Canadian Registry of Atrial Fibrillation. Am Heart J. 2004;148:649–654. - PubMed