Left Atrial Longitudinal Strain Parameters Predict Postoperative Persistent Atrial Fibrillation Following Mitral Valve Surgery: A Speckle Tracking Echocardiography Study

Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine wheth...

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Published in:	Echocardiography (Mount Kisco, N.Y.) Vol. 30; no. 9; pp. 1061 - 1068
Main Authors:	Candan, Ozkan, Ozdemir, Nihal, Aung, Soe Moe, Dogan, Cem, Karabay, Can Yucel, Gecmen, Cetin, Omaygenç, Onur, Güler, Ahmet
Format:	Journal Article
Language:	English
Published:	United States Blackwell Publishing Ltd 01.10.2013
Subjects:	Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - epidemiology Atrial Fibrillation - physiopathology Compressive Strength Echocardiography - statistics & numerical data Elastic Modulus Elasticity Imaging Techniques - statistics & numerical data Female Heart Valve Prosthesis Implantation - statistics & numerical data Humans left atrial longitudinal strain Male Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Mitral Valve - surgery postoperative atrial fibrillation Postoperative Complications - epidemiology Prevalence Prognosis Risk Assessment speckle tracking echocardiography Stress, Mechanical Tensile Strength Treatment Outcome Turkey - epidemiology postoperative atrial fibrillation mitral valve surgery left atrial longitudinal strain speckle tracking echocardiography
ISSN:	0742-2822, 1540-8175, 1540-8175
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Abstract	Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy.
AbstractList	Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy. Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy. Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy.Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied recently for evaluation of LA function. The purpose of this study was to examine whether left atrial longitudinal strain measured by STE is a predictor for the development of POAF following mitral valve surgery for severe mitral regurgitation. We studied 53 patients undergoing mitral valve surgery in sinus rhythm at the time of surgery. Echocardiography with evaluation of LA strain by STE was performed. Detection of POAF was based on documentation of AF episodes by continuous telemetry throughout hospitalization. Patients who did not develop POAF were taken as group 1 and those who had POAF constituted group 2. The echocardiographic and clinical predictors of POAF were investigated. POAF occurred in 28.3% of subjects. Mean age, LAVi and BNP were found higher in group 2 while peak atrial longitudinal strain (PALS) (13.9 ± 3.8% vs. 24.8 ± 7.3%; P < 0.001), peak atrial contraction strain (PACS) (7.6 ± 1.95% vs. 11.3 ± 3.5%; P < 0.001) were significantly lower. By multivariate logistic regression analysis, PALS and LAVi were independent predictor of POAF development. LA longitudinal strain was found to predict POAF in patients undergoing mitral valve surgery. It could be used to better identify patients at greater risk of developing POAF, and thus to guide in risk stratification and to take appropriate intensive prophylactic therapy.
Author	Omaygenç, Onur Gecmen, Cetin Güler, Ahmet Candan, Ozkan Aung, Soe Moe Karabay, Can Yucel Dogan, Cem Ozdemir, Nihal
Author_xml	– sequence: 1 givenname: Ozkan surname: Candan fullname: Candan, Ozkan email: Address for correspondence and reprint requests: Ozkan Candan, Kartal Koşuyolu Heart & Research Hospital, Cardiology Clinic, 34846 Kartal, İstanbul, Turkey. Fax: +0216-4596321;, oz_candan@hotmail.com organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 2 givenname: Nihal surname: Ozdemir fullname: Ozdemir, Nihal organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 3 givenname: Soe Moe surname: Aung fullname: Aung, Soe Moe organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 4 givenname: Cem surname: Dogan fullname: Dogan, Cem organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 5 givenname: Can Yucel surname: Karabay fullname: Karabay, Can Yucel organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 6 givenname: Cetin surname: Gecmen fullname: Gecmen, Cetin organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 7 givenname: Onur surname: Omaygenç fullname: Omaygenç, Onur organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey – sequence: 8 givenname: Ahmet surname: Güler fullname: Güler, Ahmet organization: Cardiology Clinic, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
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Snippet	Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay....
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SubjectTerms	Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - epidemiology Atrial Fibrillation - physiopathology Compressive Strength Echocardiography - statistics & numerical data Elastic Modulus Elasticity Imaging Techniques - statistics & numerical data Female Heart Valve Prosthesis Implantation - statistics & numerical data Humans left atrial longitudinal strain Male Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Mitral Valve - surgery postoperative atrial fibrillation Postoperative Complications - epidemiology Prevalence Prognosis Risk Assessment speckle tracking echocardiography Stress, Mechanical Tensile Strength Treatment Outcome Turkey - epidemiology
Title	Left Atrial Longitudinal Strain Parameters Predict Postoperative Persistent Atrial Fibrillation Following Mitral Valve Surgery: A Speckle Tracking Echocardiography Study
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