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Atrial fibrillation (AF) is a prevalent arrhythmia and the leading preventable cause of cardioembolic stroke. Scoring systems for predicting AF risk do not use imaging modalities. We sought to determine whether LA longitudinal strain could be used as a single parameter for predicting the risk of AF. Consecutive patients diagnosed with diastolic dysfunction between December 2019 and March 2020 were included. Two-dimensional, colour flow, continuous pulse-wave, and tissue Doppler transthoracic echocardiography (TTE) were performed using a Vivid E9 imaging system (GE Medical Systems, Chicago, USA). Measurements were obtained in the standard manner recommended by the American Society of Echocardiography. Moreover, LA longitudinal strain was measured using 2D speckle tracking echocardiography in the four-chamber view to evaluate left atrial function. The CHARGE-AF scoring system was used to predict AF risk. A total of 148 patients (mean age: 57.6 ± 11.9; male: 53%) with feasible views for LA strain measurement were divided into two groups based on a 10% CHARGE-AF cut-off score. The &gt;10% group (48 patients; 32%) was defined as having a predicted 5-year AF risk &gt;10%, and the ≤10% group (100 patients; 68%) was defined as having a predicted risk &lt;10%. In the multivariate analysis, LA reservoir strain (LASr) was independently associated with CHARGE-AF score. Furthermore, using the Pearson correlation method, LASr was found to be highly correlated with CHARGE-AF score ( r  = –0.74,  p  &lt; 0.0001). LASr was highly correlated with CHARGE-AF risk score and may be used as a parameter to predict atrial myopathy and hence AF risk.

Association between CHARGE-AF risk score and LA mechanics: LA reservoir strain can be a single parameter for predicting AF risk