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Atrial Function Assessed by Speckle Tracking Echocardiography Is a Good Predictor of Postoperative Atrial Fibrillation in Elderly Patients
Author(s) -
Verdejo Hugo E.,
Becerra Elia,
Zalaquet Ricardo,
Campo Andrea,
Garcia Lorena,
Troncoso Rodrigo,
Chiong Mario,
Marin Arnaldo,
Castro Pablo F.,
Lavandero Sergio,
Gabrielli Luigi,
Corbalán Ramón
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13059
Subject(s) - medicine , atrial fibrillation , cardiology , speckle tracking echocardiography , sinus rhythm , coronary artery bypass surgery , cardiac surgery , artery , ejection fraction , heart failure
Objective Advanced age is an independent predictor of postoperative atrial fibrillation ( POAF ) in patients undergoing coronary artery bypass surgery. We evaluated whether left atrial ( LA ) dysfunction assessed by strain contributes to identifying elderly patients prone to POAF . Methods Case–control study of 70 subjects undergoing coronary artery bypass surgery. Clinical and laboratory characteristics were recorded at baseline and 72 hours after surgery. Echocardiography was performed during the preoperative period; LA dimensions and deformation by strain (systolic wave [ LAS s]) as well as strain rate (systolic wave [ LASR s] and atrial contraction wave [ LASR a]) were assessed. Results Postoperative atrial fibrillation occurred in 38.5% of patients within the first 72 hours after surgery (28.5% of the younger vs. 48.6% of the older group). Baseline and postoperative inflammatory markers as well as total surgical and aortic clamp time were similar between groups. LA function was markedly impaired in subjects with POAF . Age correlated with LAS s, LASR s, and LASR a. These associations remained consistent when subjects 75 years or older were considered separately. Both LAS s and LASR a for patients with or without POAF , respectively, were significantly impaired in elderly subjects with POAF . Multivariate analysis provided further evidence that both LAS s and age are independent predictors for POAF . Conclusion Age‐related changes in atrial function preceding atrial dilation are evident only upon LA strain analysis. LA strain impairment is an independent predictor of POAF irrespective of age and may serve as a surrogate marker for biological processes involved in establishing the substrate for POAF .