Decreased longitudinal systolic strain rate of the left atrial myocardium as one of the earliest markers of atrial cardiomyopathy in subjects with brief paroxysmal atrial fibrillation

Purpose Brief paroxysmal atrial fibrillation (BPAF) is defined as episodes of atrial fibrillation (AF) lasting less than 30 seconds and can be a sign of atrial cardiomyopathy. We aimed to evaluate left atrial (LA) function in patients with BPAF. Methods This cross-sectional prospective study consecutively recruited 42 patients with BPAF on 24 to 48 hour electrocardiography Holter monitoring. We selected 50 volunteers as the control group after 24 hours electrocardiography Holter monitoring. Two-dimensional speckle-tracking echocardiography was performed to evaluate the longitudinal deformation variables of LA function. Results Strain rate during LA reservoir phase was lower (P = .018) in patients with BPAF (2.0 +/- 0.4 second(-1)) than in controls (2.2 +/- 0.5 second(-1)). This difference remained significant after adjustments for left ventricular ejection fraction, LA maximal volume, and diabetes (beta = 0.222, P = .036). Strain during LA reservoir, conduit, and contraction phases and strain rate during the conduit and contraction phases were not significantly different between the two groups. Conclusions The reservoir function of the LA evaluated by two-dimensional speckle-tracking echocardiography was lower in subjects than that without BPAF.