Correlation of left atrial strain with the recurrence of atrial fibrillation after cardioversion

Aim. To evaluate the correlation of values of left atrial (LA) strain in patients with atrial fibrillation (AF) who underwent cardioversion (CV) with AF recurrence, hospitalization or death in early and late periods after cardioversion.Material and methods. 85 patients of the University Clinical Hospital No. 1 of Sechenov University were examined: 30 men (35.3 %) and 55 women (64.7 %), the average age was 70 ± 8 years. All patients underwent speckle tracking, the parameters of LA strain and LA stiffness index were determined upon admission to the hospital after CV; after 1, 3, 6 months, a relapse of AF, the fact of hospitalization for cardiovascular reasons, and death were detected.Results. 4 people died during the follow-up, 37 hospitalizations were registered due to a relapse of AF, 7 developed a long-term persistent/permanent form of AF. The predictors associated with the onset of adverse events at the 3rd month were: reduction of the negative peak in the 4-chamber position (risk ratio (HR) 1.26, 95 % confidence interval (CI) 1.05, 1.51; p=0.009), reduction of LA strain in the 4-chamber position (HR 0.85, CI 0.75, 0.96; p=0.007), reduction of positive strain peaks in the 4-chamber (HR 0.44, CI 0.25, 0.77; p<0.001) position. When analyzing the data of the sixth month of observation, the predictors were: reduction of negative strain peak in 4-chamber (HR 1.33, CI 1.05, 1.69, p=0.009) and 2-chamber (HR 1.23, CI 1.01, 1.5; p=0.029) positions, reduction of global longitudinal strain LA (HR 0.83, CI 0.72, 0.95; p=0.004), high left atrial stiffness index (HR 15.3, CI 6.56, 35.9; p<0.001).Conclusion. Evaluation of LA strain parameters during speckle- tracking may be promising in patients with AF after CV, since their decrease correlates well with the risk of adverse events in the long-term periods (3 and 6 months after CV).