Echocardiographic assessment of left atrial remodeling as a predictor for the nonvalvular atrial fibrillation recurrence

Aim: The evaluation of echocardiographic parameters and indication of various methods of measurement of the left atrium (LA) size. To find an appropriate parameter which would be the most precise predictor for the atrial fibrillation (AF) recurrence. Methods and results: A prospective analysis was executed during the period of June 2016 to June 2018. The inclusion criteria were non-valvular AF and planned electric cardioversion. Monitored parameters: anatomical parameters (LA size in M-mode, LA capacity measured by the Simpson's method) and functional parameters (reservoir function evaluation via 3D echocardiography, LA EF and 2D speckle tracking, LA strain). The statistical analysis was carried out via the STATISTICA Cz 10 programme. We examined 56 patients in total, after application of the exclusion criteria, we analysed 36 patients in two intervals (after 1st and 6th month). The average age of our group was 60 +/- 17 years. Men and patients with persisting AF predominated in our group. Upon the comparison of the anatomic and functional parameters of LA, as the predictor of the AF recurrence, the functional parameters showed to be statistically significant. In the group with a sinus rhythm the value of LA EF and LA GLS was much higher compared to the group with AF (LA EF: 38.3 +/- 6.4 vs 28.5 +/- 3.20; LA GLS: 18.5 +/- 5.32 vs 9.7 +/- 5.10, p <0.001). When applying the 3D LA volumetry, the difference between the endsystolic volumes (ml/m(2)) in the group with a sinus rhythm compared to the AF (21.5 +/- 9.08 vs 26.8 +/- 4.44, p <0.05) turned out as statistically significant. Conclusion: The anatomical parameters, as the predictors of the AF recurrence risk turned out as statistically insignificant. The functional LA parameters turned out statistically significant. The fact that there are new techniques for evaluation of the LA function helps us improve the prediction of the cardiovascular events, as well as the stratification of the patients concerning the AF.