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Impact of disease stage on the performance of strain markers in the prediction of atrial fibrillation

Ramkumar, S, Pathan, F ORCID: 0000-0002-0939-5470, Kawakami, H, Ochi, A, Yang, H, Potter, EL and Marwick, TH ORCID: 0000-0001-9065-0899 2020 , 'Impact of disease stage on the performance of strain markers in the prediction of atrial fibrillation' , International Journal of Cardiology , pp. 1-9 , doi: 10.1016/j.ijcard.2020.09.057.

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Background: Assessing atrial fibrillation (AF) risk may be useful in primary prevention (PP; people with risk factors) and secondary prevention (SP; eg. embolic stroke of unknown source). We sought whether disease stage influenced the prediction of AF by echocardiography. Methods: We compared a PP cohort (351 community-based participants ≥65 years with ≥1 risk factor for AF) and a SP cohort (453 patients after transient ischemic attack or stroke). LV global longitudinal strain (GLS) and left atrial reservoir strain (LARS) were measured from DICOM images. AF was diagnosed by 12 lead ECG, Holter or by single lead monitor over median follow-up of 22 months (PP) and 35 months (SP). The clinical and echocardiographic characteristics of those with AF were compared to those in sinus rhythm. Nested Cox-regression models assessed for independent and incremental predictive value of LARS and GLS in both cohorts. Results: AF developed in 42 PP (12%) and 60 SP (13%), and was associated with age, higher CHARGE-AF score, increased LA volume and LV mass (p p p p p p Conclusion: AF risk assessment with LARS is suitable for different risk cohorts, but GLS is more useful in SP.

Item Type: Article
Authors/Creators:Ramkumar, S and Pathan, F and Kawakami, H and Ochi, A and Yang, H and Potter, EL and Marwick, TH
Keywords: atrial fibrillation, left atrium, screening, strain
Journal or Publication Title: International Journal of Cardiology
Publisher: Elsevier Sci Ireland Ltd
ISSN: 0167-5273
DOI / ID Number: 10.1016/j.ijcard.2020.09.057
Copyright Information:

© 2020 Published by Elsevier B.V.

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