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Comparative Study
. 2024 Aug;40(8):1725-1734.
doi: 10.1007/s10554-024-03162-3. Epub 2024 Jun 19.

Feasibility of left atrial strain assessment using cardiac computed tomography in patients with paroxysmal atrial fibrillation

Takaaki Hosokawa #  1 , Hiroshi Kawakami #  2 , Yuki Tanabe  3 , Kazuki Yoshida  3 , Yuka Endo  3 , Fumiaki Tamai  3 , Hikaru Nishiyama  3 , Naoki Fukuyama  3 , Katsuji Inoue  2 , Osamu Yamaguchi  2 , Teruhito Kido  3
Affiliations
Comparative Study

Feasibility of left atrial strain assessment using cardiac computed tomography in patients with paroxysmal atrial fibrillation

Takaaki Hosokawa et al. Int J Cardiovasc Imaging. 2024 Aug.

Abstract

Purpose: To evaluate the feasibility of left atrial strain (LAS) assessment using cardiac computed tomography (CT) in patients with paroxysmal atrial fibrillation (PAF).

Methods: This retrospective single-center study included 98 patients with PAF who underwent cardiac CT and echocardiography before the first catheter ablation. LAS was analyzed using cardiac CT (CT-LAS) and speckle-tracking echocardiography (STE; STE-LAS). LA reservoir (LASr), conduit (LASc), and pump strain (LASp) were calculated by averaging LAS measured in 4- and 2-chamber views. The results were compared using Pearson's correlation coefficients, paired t-tests, and Bland-Altman analysis. Intraclass correlation coefficients (ICCs) were used to evaluate reproducibility.

Results: CT-LAS could be analyzed in all patients, while STE-LAS could be analyzed in 53 (54%) patients. LASr, LASc, and LASp showed significant correlations between CT- and STE-LAS: LASr, r = 0.68, p < 0.001; LASc, r = 0.47, p < 0.001; LASp, r = 0.67, p < 0.001. LASr, LASc, and LASp of CT- and STE-LAS were 23.7 ± 6.0% and 22.1 ± 6.7%, 11.1 ± 3.6% and 11.1 ± 4.1%, and 12.6 ± 4.6% and 11.0 ± 4.1%, respectively. LASr and LASp were significantly higher in CT-LAS than that in STE-LAS (p = 0.023 for LASr and p = 0.001 for LASp). CT-LAS showed excellent reproducibility. The intra- and interobserver ICCs were 0.96 to 0.99 and 0.89 to 0.90, respectively.

Conclusion: CT-LAS was successfully analyzed in more patients than STE-LAS and was highly reproducible. The findings suggest that CT-LAS is feasible for patients with PAF.

Keywords: Atrial fibrillation; Computed tomography; Left atrial function; Left atrial strain.

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