Three‐Dimensional Speckle Tracking Echocardiography–Derived Left Atrial Strain Parameters Are Reduced in Patients with Atrial Fibrillation (Results from the MAGYAR‐Path Study)

Objective: Three‐dimensional (3D) speckle tracking echocardiography (3 DSTE ) is a novel imaging modality for assessing cardiac function. We aimed to analyze left atrial ( LA ) function using 3 DSTE in patients with atrial fibrillation ( AF ). Methods: 3 DSTE was performed in 20 patients prior to their pulmonary vein isolation for AF . Every patient underwent a complete two‐dimensional echocardiographic study at the same time. 3 DSTE ‐derived circumferential ( CS ), longitudinal ( LS ), radial ( RS ), 3D (3 DS ), and area strain ( AS ) values were measured in the basal (b), mid (m), and superior (s) regions of the LA . 3 DSTE ‐defined maximal ( LA max ) and minimal LA volumes ( LA min ) and LA total emptying fraction were calculated automatically. Eleven randomly selected age‐ and gender‐matched healthy volunteers served as controls. Results: Patients with AF had significantly larger LA max and LA min and reduced LS , RS and CS .3 DS and AS were significantly lower throughout the LA in cases with AF (3 DS −b, −m, −s [ AF patients vs. controls]: −18 ± 8% vs. −29 ± 8%, P = 0.001; −14 ± 6% vs. −22 ± 7%, P = 0.002; −10 ± 7% vs. −20 ± 9%, P = 0.002; AS −b, −m, −s [ AF patients vs. controls]: 35 ± 15% vs. 52 ± 13%, P = 0.004; 50 ± 21% vs. 72 ± 19%, P = 0.009; 31 ± 21% vs. 65 ± 27%, P < 0.0001, respectively). Conclusions: 3 DSTE ‐derived “uni‐dimensional” LS , RS , CS , as well as novel strain parameters (3 DS , AS ) are significantly reduced in patients with AF compared to matched controls. 3 DS and AS might be new strain parameters providing further insights into the alterations of LA function in patients developing AF .