CONGRESS ABSTRACT

Background and Purpose: Atrial fibrillation is a progressive condition characterized by structural, functional, and electrical remodeling of the left atrium (LA). Left atrial strain (LAS), assessed using speckle-tracking imaging, is a sensitive marker of atrial function. A reduction in LAS has been linked to atrial remodeling and an increased risk of adverse cardiovascular events. This study aims to compare left atrial strain parameters between healthy individuals and patients with paroxysmal atrial fibrillation (PAF) to assess the extent of atrial dysfunction in PAF. Methods: This observational study included 20 participants, divided into two groups: 10 healthy controls and 10 patients with PAF (Table 1). All participants underwent comprehensive transthoracic echocardiography (TTE), including speckle-tracking analysis to assess LAS during reservoir (LASr), conduit (LAScd), and contractile (LASct) phases. LAS analysis was performed using the GE Q-analysis application (GE Vivid E80). Echocardiographic parameters were compared between the two groups. Results: In this study, left ventricular (LV) parameters, including LV ejection fraction (EF), indexed volumes, and global longitudinal strain (GLS), did not differ significantly between the two groups. Significant differences were observed in LA parameters. LA volume (LAV) was considerably larger in the PAF group compared to controls (LAV: 68.9±21.0 vs. 48.7±13.0, p=0.045; LAV indexed: 35.6±10.9 vs. 27.2±4.7, p=0.029). Left atrial fractional area-change (LA FAC) was significantly lower in PAF patients (34.0±5.6 vs. 44.0±5.4, p=0.003); LASr and LASct were significantly reduced in PAF patients compared to healthy controls (respectively: 27.7±6.2 vs. 34.9±6.4%, p=0.025; -11.7±3.6 vs. -14.8±2.6, p=0.037). In contrast, LAScd did not differ significantly between the groups (-16.1±7.5 vs. -20.1±6.7, p=0.273). (Table 2). Conclusion: This study suggests that patients with PAF may have structural and functional changes, as evidenced by LA enlargement and significant reductions in LAS during the reservoir and contractile phases compared to healthy controls. These findings suggest that detectable alterations in the left atrium may occur in patients with PAF. Larger studies with longer follow-ups are needed to determine whether LAS could be a reliable marker for assessing atrial dysfunction and predicting the risk of PAF-related adverse events