Assessment of Left Atrial Function and Remodeling in Patients With Atrial Fibrillation by Performing Strain Echocardiography: A Prospective Study to Assess the Influence of Renin-Angiotensin

Background and Objectives: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocar-diography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. Subjects and Methods: Strain echocardiogra-phy is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, non-used group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. Results: Six pa-tients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E’, strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71±13.63 % and 2.98±0.59s-1, p<0.05, respectively) than group B (27.21±10.49 % and 2.21± 0.47s-1). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89±3.30 % and-2.3