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European Journal of Echocardiography Advance Access published online on September 10, 2007
European Journal of Echocardiography, doi:10.1016/j.euje.2007.07.003
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Atrial myocardial deformation properties are temporarily reduced after cardioversion for atrial fibrillation and correlate well with left atrial appendage function

Ergün Baris Kaya1,*, Lale Tokgözoglu1, Kudret Aytemir1, Ugur Kocabas1, Erol Tülümen1, Onur Sinan Deveci1, Sedat Köse2, Giray Kabakçi1, Nasih Nazli1, Hilmi Özkutlu1 and Ali Oto1

1 Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey
2 Department of Cardiology, Gülhane Military Medical Academy, Ankara, Turkey

Received 7 May 2007; accepted after revision 16 July 2007.

* Corresponding author. Tel: +90 312 305 1780. E-mail address: doctorkaya{at}yahoo.com (E. Baris Kaya).


  Abstract

Aim: This study was conducted to evaluate whether left atrial strain and strain rate correlate well with transesophageal parameters of stunning after atrial fibrillation.

Methods and results: Twenty-two consecutive patients with chronic atrial fibrillation ≥3 months and <1 year were enrolled in the study. Transthoracic (TTE) and transesophageal (TEE) echocardiography with color Doppler myocardial imaging were performed before, 1 day after and 10 days after successful cardioversion. Left atrial transthoracic strain (S) and strain rate (SR) from lateral, inferior and anterior atrial walls, left atrial appendage tissue velocities, strain and strain rate values were measured with offline analysis. Left atrial appendage emptying (LAAEV) and filling (LAAFV) velocities were obtained from transesophageal echocardiography.

Left atrial transthoracic, and left atrial appendage strain and strain rates were significantly lower following 1 day after cardioversion (TTE S/SR, 5.0 ± 2.8%/2.3 ± 1.0; TEE (septal) S/SR, 7.6 ± 3.6%/1.6 ± 0.7). There was a good correlation between these parameters and LAAEV (LA systolic strain and LAAEV, r = 0.73, P = 0.007). Left atrial and LAA strain and strain rate values improved over time, and correlated well with LAAEV, measured 10 days after cardioversion.

Conclusions: Transthoracic atrial and TEE LAA strain and strain rate, which are quantitative measures of atrial function, are reduced after cardioversion, and recover subsequently. The good correlation between LAA function and TTE strain and strain rate suggests that TTE atrial parameters may help determine duration of anticoagulation.

Keywords: Atrial fibrillation; Atrial stunning; Strain echocardiography


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