Left ventricular systolic function assessed by global longitudinal strain is impaired in atrial fibrillation compared to sinus rhythm

Bue F. Ross Agner, Michael G. Katz, Zachary R. Williams, Ulrik Dixen, Gorm B. Jensen, Karl Q. Schwarz

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: Atrial fibrillation (AF) is the most common aberrant cardiac arrhythmia. Many AF patients present with symptoms of dyspnea and fatigue, but have normal left ventricular ejection fraction (LVEF). Purpose: To determine the reproducibility of measurements of global longitudinal strain (GLS) and strain rate in patients with AF and examine if the arrhythmia is associated with abnormal LV strain and strain rate independent of age, sex, heart rate, LVEF and LV mass. We hypothesized that AF independently reduces ventricular systolic performance. Methods: The study was conducted as a retrospective analysis of images from 150 randomly selected patients with AF compared to an equal number of subjects with sinus rhythm (SR) matched for age, sex, heart rate, LVEF and LV mass. Half of the patients had normal LVEF (LVEF > 50%) and half had reduced LVEF (LVEF < 50%). GLS and strain rate were measured in each group, as were quantitative LV volumes and standard systolic and diastolic parameters. Results: GLS was significantly impaired in patients with AF compared to subjects with SR, both in the overall population (-12.25 ± 4.1% vs. -16.13 ± 4.7%, p<0.0001), in patients with normal LVEF (-14.41 ± 3.9% vs. -19.42 ± 3.1%, p<0.0001) and in patients with reduced LVEF (-10.10 ± 3.1% vs. -12.85 ± 3.5%, p<0.0001). Linear regression and Bland Altman analyses demonstrated good intraobserver and interobserver agreement for measurements of GLS and strain rate parameters even in patients with AF. Conclusions: Measurements of GLS and strain rate parameters are reproducible in patients with AF. Patients with AF have significantly impaired values of GLS when compared to similar patients with SR independent of age, sex, heart rate, LVEF and LV mass.

Original languageEnglish
JournalJournal of Atrial Fibrillation
Volume10
Issue number4
DOIs
StatePublished - 1 Dec 2017
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Diastolic strain rate
  • Global longitudinal strain
  • Left ventricular systolic function
  • Systolic strain
  • Systolic strain rate

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