Assessment of left atrium mechanical function by deformation imaging in atrial fibrillation and its correlation with CHA2DS2-VASc risk score

Objectives: Evaluation of left atrium (LA) mechanical function by speckle tracking based strain (SPTS) in patients with chronic non-valvular atrial fibrillation (AF) and its correlation with CHA2DS2-VASc risk score. Background: AF is a progressive condition that begins with increased hemodynamic load or structural remodeling of the atria, understanding atrial function could lead to better ability to predict the risk of developing stroke and the response to treatment. SPTS is a recently emerged modality that accurately estimates myocardial function. Methods: Sixty patients with chronic AF and 20 age and sex matched normal control individuals underwent conventional echo where LV dimensions, wall thickness, EF, LA diameter and volumes were measured. Peak left atrial longitudinal strain (PALS) was measured in apical four (AP4) and two chamber view (AP2) and its correlation with CHA2DS2-VASc risk score in the AF group was evaluated. Results: LA diameter and volumes were greater in AF patients (P-value < 0.001). PALS in each LA wall and in both AP4 and AP2 views were highly significantly lower in AF patients in comparison with control but did not reach a statistically significant correlation with CHA2DS2-VASc score. Also, there was no significant difference between PALS in patients with CHA2DS2-VASc score less than and more than two points. Conclusion: AF leads to impairment of LA mechanical function as evidenced by low PALS but PALS was not significantly correlated with CHA2DS2-VASc score. Also, there was no significantly statistical difference between PALS in patients with low and high CHA2DS2-VASc scores