2D strain echocardiography of the right atrium in patients with paroxysmal or persistent atrial fibrillation

Have, E. ten (Els) (2016) 2D strain echocardiography of the right atrium in patients with paroxysmal or persistent atrial fibrillation. thesis, Medicine.

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Abstract

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia. It has a prevalence of 1-2% in the European population. AF is accompanied with atrial remodeling e.g. fibrosis and dilatation which affect the atrial functions. These can be divided in a reservoir, conduit and contraction phase. Using ‘Speckle Tracking Echocardiography’ (STE) it is possible to measure atrial function by performing strain analysis. Left atrial (LA) strain is extensively studied but there is a lack of data for the right atrium, especially in patients with AF. The purpose of this study is to measure right atrial (RA) strain and compare/relate this to LA strain. Also RA strain will be related to different clinical parameters and AF progression after 1 year. Method/results: Strain and volumetric measurements were performed on 350 baseline echoes from the AF-RISK population. These patients were included having short-lasting symptomatic AF. RA strain in respectively the reservoir, conduit and contraction phase was 44.6±11.8%, 24.4±9.1% and 19.8±6.6%. RA strain values agreed with the healthy population in the literature while LA strain was decreased. The sensitivity of atrial volume index predicting low strain was 93.8% for right and 96.5 % for left. Best predictors for RA reservoir strain were ‘right atrial volume index’ (RAVI) and Mean e’. For contraction strain these were age, TAPSE, LA contraction strain and RAVI. Conclusion: In a population of 350 patients with short-lasting symptomatic AF, LA strain is decreased while RA strain is preserved. Atrial dilatation is associated with low strain. Our findings suggest for a process in which functional changes precede structural changes and left atrial function is earlier affected compared to right atrial function.

Item Type:	Thesis (Thesis)
Supervisor name:	supervisor: and Melle, Dr. J.P. van and 2e supervisor: and With, Drs R.R. de and UMCG, Department of Cardiology
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:03
Last Modified:	25 Jun 2020 11:03
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2303

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