Assessment of left atrial mechanical function and synchrony in paroxysmal atrial fibrillation with two-dimensional speckle tracking echocardiography
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Updated: Mar 7, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Zhijuan Shang1, Dechun Su2, Tao Cong2
1Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China.
Background:
The aim of this study was to investigate left atrial (LA) function and synchrony in paroxysmal atrial fibrillation (PAF) patients using two-dimensional speckle tracking echocardiography (STE).
Methods:
Forty-five PAF patients and 30 healthy controls were enrolled. LA peak ventricular systolic longitudinal strain (LAS-S ) and strain rate (LASR-S ) and left atrial longitudinal strain (LAS-A ) and strain rate (LASR-A ) during late diastole were determined using STE, and the standard deviation of the time to peak (TPSD) of the regional strains was calculated to quantify LA dyssynchrony. TPSD during ventricular systole and late diastole were named SDs and SDa, respectively.
Results:
Left atrial peak longitudinal strain during ventricular systole (LAS-S ) (29.34±8.57 vs 36.73±6.13), LASR-S (1.27±0.311 vs 1.57±0.25), LAS-A (13.11±4.91 vs 17.86±3.57), and LASR-A (-1.51±0.58 vs -1.90±0.30) were reduced in the PAF group compared with the controls (P<.05 for all). SDs (8.11±3.00% vs 4.67±1.48%) and SDa (5.57±2.26% vs 3.11±1.13%) were greater in PAF patients than in the controls (P<.05 for both). Furthermore, PAF patients with normal LA sizes exhibited lower LAS-S (P<.05), LASR-S (P<.05), LAS-A (P<.05), and LASR-A (P<.05) values and increased SDs (P<.05) and SDa (P<.05) values compared with the controls. Multivariate regression confirmed that SDs and SDa were powerful parameters for differentiating PAF patients from controls (SDs: sensitivity, 83%; specificity, 72%; SDa: sensitivity, 81%; specificity, 76%).
Conclusions:
Left atrial (LA) dysfunction and dyssynchrony in PAF patients can be detected with STE even in the absence of LA enlargement. STE-derived SDs and SDa were powerful parameters for identifying PAF patients.
