Left atrial mechanical function and stiffness in patients with atrial septal aneurysm: a speckle tracking study

Atrial septal aneurysm (ASA) is a risk factor for arterial embolism. Atrial dysfunction and atrial arrhythmia, such as atrial fibrillation, might represent a mechanism for arterial embolism in such patients. Speckle tracking echocardiography (STE) is a novel and promising tool for detecting early changes in left atrial (LA) myocardial dysfunction. The aim of the study was to evaluate LA mechanical function and stiffness in ASA patients by 2-dimensional STE strain parameters.

Thirty-four ASA patients (44.2 ± 12.3 years, 15 male) were studied, using a STE, and were compared with 31 age, gender, and left ventricular (LV) mass-matched controls (41.8 ± ± 11.5 years, 14 male). LA volume indices, mitral annular velocities, and global longitudinal LA strain were measured. The ratio of E/e' to LA strain was used as an index of LA stiffness.

Patients with ASA showed increased LA volume indices and decreased LA global strain (25.3 ± 5.2 vs. 42.1 ± 8.7, p < 0.001). LA stiffness was increased in patients with ASA compared to the control subjects (0.41 ± 0.15 vs. 0.14 ± 0.05, p < 0.001), and LA strain and stiffness were related with LA volume indices.

Patients with ASA have decreased LA global strain and increased stiffness, in comparison with those of the control subjects. LA strain and stiffness were significantly related with LA volume indices. LA stiffness and strain can be used for the assessment of LA function in patients with ASA.