Atrial fibrillation per se was a major determinant of global left ventricular longitudinal systolic strain

作者：Lee Hung Hao; Lee Meng Kuang; Lee Wen Hsien; Hsu Po Chao; Chu Chun Yuan; Lee Chee Siong; Lin Tsung Hsien; Voon Wen Chol; Lai Wen Ter; Sheu Sheng Hsiung; Su Ho Ming^*

来源：Medicine, 2016, 95(26): e4038.

DOI：10.1097/MD.0000000000004038

• atrial fibrillation
• global longitudinal systolic strain
• left ventricular systolic function

Atrial fibrillation (AF) may cause systolic abnormality via inadequate diastolic filling and tachycardia-induced cardiomyopathy. Global longitudinal strain (GLS) is a very sensitive method for detecting subtle left ventricular systolic dysfunction. Hence, this study aimed to evaluate whether AF patients had a more impaired GLS, AF was a major determinant of GLS, and determine the major correlates of GLS in AF patients.The study included 137 patients with persistent AF and left ventricular ejection fraction (LVEF) above 50% and 137 non-AF patients matched according to age, gender, and LVEF. Comprehensive echocardiography with GLS assessment was performed for all cases.Compared with non-AF patients, AF patients had a more impaired GLS, a larger left atrial volume index, higher transmitral E wave velocity (E), and early diastolic mitral velocity (Ea) (all P<0.001) but comparable E/Ea. After adjustment for baseline and echocardiographic characteristics, the presence of AF remained significantly associated with impaired GLS ( = 0.533, P<0.001). In addition, multivariate analysis of AF patients indicated that faster heart rates and decreased E, Ea, and LVEF were associated with more impaired GLS.This study demonstrated that AF patients had a more impaired GLS than non-AF patients, although LVEF was comparable between the 2 groups. AF was a major determinant of GLS even after adjustment for relevant clinical and echocardiographic parameters.

• 出版日期2016-6