Objective: Atrial cardiomyopathy is closely associated with atrial fibrillation (AF), and some patients exhibit no dysfunction at rest but demonstrate evident changes in left atrial (LA) function and LA volume during exercise. This study aimed to identify distinguishing signs during exercise stress echocardiography (ESE) among patients in sinus rhythm (SR), with and without history of paroxysmal/persistent AF (PAF). Methods: A prospective cohort of 1055 patients in SR was enrolled across 12 centers. The main study cohort was divided into two groups: the modeling group (n = 513) and the verification group (n = 542). All patients underwent ESE, which included B-lines, LA volume index (LAVi), and LA strain of the reservoir phase (LASr). Results: Age, resting and stress LAVi and LASr, and B-lines were identified as a combination of detectors for PAF in both groups. The composite score, summing all 9 items, yielded a score of > 4 as the best sensitivity (79%) and specificity (65%). Conclusion: ESE can complement rest echocardiography in the identification of previous PAF in patients with SR through the evaluation of LA functional reservoir and volume reserve, LV chronotropic, diastolic, and systolic reserve, and RV contractile reserve.
Left atrial function during exercise stress echocardiography as a sign of paroxysmal/persistent atrial fibrillation / Zagatina A., Ciampi Q., Peteiro J.V., Kalinina E., Begidova I., Padang R., Boshchenko A., Merli E., Lisi M., Rodriguez-Zanella H., Kobal S., Agoston G., Varga A., Wierzbowska-Drabik K., Kasprzak J.D., Arbucci R., Zhuravleva O., Celutkiene J., Lowenstein J., Ratanasit N.C., et al.. - In: CARDIOVASCULAR ULTRASOUND. - ISSN 1476-7120. - ELETTRONICO. - 22:(2024), pp. 13.0-13.0. [10.1186/s12947-024-00332-0]
Left atrial function during exercise stress echocardiography as a sign of paroxysmal/persistent atrial fibrillation
Varga A.;Manganelli F.;Dentamaro I.;Rigo F.;Citro R.;Del Franco A.;Olivotto I.;D'Alfonso M. G.;
2024
Abstract
Objective: Atrial cardiomyopathy is closely associated with atrial fibrillation (AF), and some patients exhibit no dysfunction at rest but demonstrate evident changes in left atrial (LA) function and LA volume during exercise. This study aimed to identify distinguishing signs during exercise stress echocardiography (ESE) among patients in sinus rhythm (SR), with and without history of paroxysmal/persistent AF (PAF). Methods: A prospective cohort of 1055 patients in SR was enrolled across 12 centers. The main study cohort was divided into two groups: the modeling group (n = 513) and the verification group (n = 542). All patients underwent ESE, which included B-lines, LA volume index (LAVi), and LA strain of the reservoir phase (LASr). Results: Age, resting and stress LAVi and LASr, and B-lines were identified as a combination of detectors for PAF in both groups. The composite score, summing all 9 items, yielded a score of > 4 as the best sensitivity (79%) and specificity (65%). Conclusion: ESE can complement rest echocardiography in the identification of previous PAF in patients with SR through the evaluation of LA functional reservoir and volume reserve, LV chronotropic, diastolic, and systolic reserve, and RV contractile reserve.
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