Register
Forgot your password?

Modern ultrasound techniques in the assessment of left atrium structural abnormalities in patients with atrial fibrillation

Authors: Mollaeva D.D., Mashina T.V., Mrikaev D.V., Berdibekov B.Sh., Filatov A.G., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

For correspondence:  Sign in or register.

Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2021-15-1-48-60

For citation: Mollaeva D.D., Mashina T.V., Mrikaev D.V., Berdibekov B.Sh., Filatov A.G., Golukhova E.Z. Modern ultrasound techniques in the assessment of left atrium structural abnormalities in patients with atrial fibrillation. Creative Cardiology. 2021; 15 (2): 48–60 (in Russ.). DOI: 10.24022/1997-3187-2021-15-1-48-60

Received / Accepted:  05.03.2021 / 12.03.2021

Keywords: atrial fibrillation echocardiography remodeling of left atrium speckle tracking radiofrequency ablation

Full text:  

 

Abstract

The incidence of atrial fibrillation (AF) and its recurrence after treatment increase every year. The evolution of diagnostic research methods, such as echocardiography and magnetic resonance tomography, provides an opportunity to evaluate the structures of the heart in detail and identify its significant changes, sometimes before the manifestation of the first symptoms. This review article is about structural and functional remodeling of left atrium in patients with various forms of atrial fibrillation based on the Speckle Tracking (STE) method. In particular the quantitative analysis of the parameters of left atrial longitudinal deformation (strain) and the deformation rate (strain rate) was distinguished. A detailed study of left atrial deformation can be a predictor of success after different variants of catheter AF surgery. Use of the new high-tech catheters can increase the success of the surgery for AF and reduce the AF recurrence.

References

  1. Revishvili A.Sh., Slyakhto E.V., Sulimov V.A., Rzaev F.G., Gorev M.V., Nardaya Sh.G. Clinical guidelines. 2017; 4: 468–70 (in Russ.).
  2. Go A.S., Hylek E.M., Phillips K.A., Chang Y., Henault L.E., Selby J.V. et al. Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. JAMA. 2001; 285 (18): 2370-5. DOI: 10.1001/jama.285.18.2370
  3. Miyasaka Y., Barnes M.E., Gersh B.J., Cha S.S., Bailey K.R., Abhayaratna W.P. et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006; 114 (2): 119–25. DOI: 10.1161/CIRCULATIONAHA.105.595140
  4. Fuster V., Rydén L.E., Cannom D.S., Crijns H.J., Curtis A.B., Ellenbogen K.A. et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation – executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). J. Am. Coll. Cardiol. 2006; 48 (4): 854–906. DOI: 10.1016/j.jacc.2006.07.009
  5. Chugh S.S., Havmoeller R., Narayanan K., Singh D., Rienstra M., Benjamin E.J. et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014; 129: 837–47. DOI: 10.1161/CIRCULATIONAHA.113.005119
  6. Béjot Y., Rouaud O., Jacquin A., Osseby G., Durier J., Manckoundia P. et al. Stroke in the very old: Incidence, risk factors, clinical features, outcomes and access to resources – a 22-year population-based study. Cerebrovasc. Dis. 2010; 29 (2): 111–21. DOI: 10.1159/000262306
  7. Stepanchuk A.P. The device of the atrial cavities of the human heart. 2011; 2: 50–5 (in Russ.).
  8. Kushakovskiy M.S. Atrial fibrillation (causes, mechanisms, clinical forms and prevention). Saint-Petersburg; 1999 (in Russ.).
  9. Barsamyan C. Zh., Davtyan K.V., Aleksandrova S.A., Revishvili A.Sh. Radiofrequency ablation of the left pulmonary vein collector with atypical location of the left atrial appendage. Journal of Arrhythmology. 2012; 68: 66–8 (in Russ.).
  10. Cong Z., Jiang B., Lu J., Cong Y., Fu J., Jin M. et al. A potentially new phase of the cardiac cycle: Pre-isovolumic contraction recognized by echocardiography. Medicine (Baltimore). 2018; 97 (21): e10770. DOI: 10.1097/MD.0000000000010770
  11. Cianciulli T.F., Saccheri M.C., Lax J.A., Bermann A.M., Ferreiro D.E. Two-dimensional speckle tracking echocardiography for the assessment of atrial function. World J. Cardiol. 2010; 2 (7): 163–70. DOI: 10.4330/wjc.v2.i7.163
  12. Nattel S., Harada M. Atrial remodeling and atrial fibrillation: recent advances and translational perspectives. J. Am. Coll. Cardiol. 2014; 63 (22): 2335–45. DOI: 10.1016/j.jacc.2014.02.555
  13. Thomas L., Abhayaratna W.P. Left atrial reverse remodeling: mechanisms, evaluation, and clinical significance. JACC Cardiovasc. Imaging. 2017; 10 (1): 65–77. DOI: 10.1016/j.jcmg.2016.11.003
  14. Schotten U., Verheule S., Kirchhof P., Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol. Rev. 2011; 91 (1): 265–325. DOI: 10.1152/physrev.00031.2009
  15. Krijthe B.P., Heeringa J., Kors J.A., Hofman A., Franco O.H., Witteman J. et al. Serum potassium levels and the risk of atrial fibrillation: the rotterdam study. Int. J. Cardiol. 2013; 168 (6): 5411–5. DOI: 10.1016/j.ijcard.2013.08.048
  16. Lu Y.Y., Cheng C.C., Chen Y.C., Lin Y.K., Chen S.A., Chen Y.J. Electrolyte disturbances differentially regulate sinoatrial node anpulmonary vein electrical activity: a contribution to hypokalemia- or hyponatremia-induced atrial fibrillation. Heart Rhythm. 2016; 13 (3): 781–8. DOI: 10.1016/j.hrthm.2015.12.005
  17. Khan A.M., Lubitz S.A., Sullivan L.M., Sun J.X., Levy D., Vasan R.S. et al. Low serum magnesium and the development of atrial fibrillation in the community: the Framingham Heart Study. Circulation. 2013; 127 (1): 33–8. DOI: 10.1161/CIRCULATIONAHA.111.082511
  18. Kallergis E.M., Manios E.G., Kanoupakis E.M., Mavrakis H.E., Arfanakis D.A., Maliaraki N.E. et al. Extracellular matrix alterations in patients with paroxysmal and persistent atrial fibrillation: biochemical assessment of collagen type-I turnover. J. Am. Coll. Cardiol. 2008; 52 (3): 211–5. DOI: 10.1016/j.jacc.2008.03.045
  19. Bosch N.A., Cimini J., Walkey A.J. Atrial fibrillation in the ICU. Chest. 2018; 154 (6): 1424–34. DOI: 10.1016/j.chest.2018.03.040
  20. Mochizuki A., Yuda S., Oi Y., Kawamukai M., Nishida J., Kouzu H. et al. Assessment of left atrial deformation and synchrony by three-dimensional speckle-tracking echocardiography: comparative studies in healthy subjects and patients with atrial fibrillation. J. Am. Soc. Echocardiogr. DOI: 2013; 26 (2): 165–74. DOI: 10.1016/j.echo.2012.10.003
  21. Yasuda R., Murata M., Roberts R., Tokuda H., Minakata Y., Suzuki K. et al. Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation. Eur. Heart J. Cardiovasc. Imaging. 2015; 16: 1008–14. DOI: 10.1093/ehjci/jev028
  22. Melenovsky V., Hwang S.J., Redfield M.M., Zakeri R., Lin G., Borlaug B.A. Left atrial remodeling and function in advanced heart failure with preserved or reduced ejection fraction. Circ. Heart Fail. 2015; 8: 295–303. DOI: 10.1161/CIRCHEARTFAILURE.114.001667
  23. Sugimoto T., Bandera F., Generati G., Alfonzetti E., Bussadori C., Guazzi M. Left atrial function dynamics during exercise in heart failure: pathophysiological implications on the right heart and exercise ventilation inefficiency. JACC Cardiovasc. Imaging. 2017; 10: 1253–64. DOI: 10.1016/j.jcmg.2016.09.021
  24. Russo C., Jin Z., Homma S., Rundek T., Elkind M.S.V., Sacco R.L. et al. LA Phasic volumes and reservoir function in the elderly by realtime 3D echocardiography: normal values, prognostic significance, and clinical correlates. JACC Cardiovasc. Imaging. 2017; 10: 976–85. DOI: 10.1016/j.jcmg.2016.07.015
  25. Leitman M., Lysyansky P., Sidenko S., Shir V., Peleg E., Binenbaum M. et al. Two-dimensional strain – a novel software for real-time quantitative echocardiographic assessment of myocardial function. J. Am. Soc. Echocardiogr. 2004; 17 (10): 1021–9. DOI: 10.1016/j.echo.2004.06.019
  26. Rosca M., Lancellotti P., Popescu B.A., Piérard L.A. Left atrial function: pathophysiology, echocardiographic assessment, and clinical applications. Heart. 2011; 97 (23): 1982–9. DOI: 10.1136/heartjnl-2011-300069
  27. Bockeria L.A., Alyokhin M.N., Mshina T.V., Mrikaev D.V., Golukhova E.Z. Modern ultrasound technologies in cardiology and cardiac surgery. М.; 2018.
  28. Cameli M., Lisi M., Righini F.M., Mondillo S. Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovasc. Ultrasound. 2012; 10: 4. DOI: 10.1186/1476-7120- 10-4
  29. Vieira M.J., Teixeira R., Gonçalves L., Gersh B.J. Left atrial mechanics: echocardiographic assessment and clinical implications. J. Am. Soc. Echocardiogr. 2014; 27 (5): 463–78. DOI: 10.1016/j.echo.2014.01.021
  30. Hoit B.D. Left atrial size and function: role in prognosis. J. Am. Coll. Cardiol. 2014; 63 (6): 493–505. DOI: 10.1016/j.jacc.2013.10.055
  31. Hayashi S., Yamada H., Bando M., Saijo Y., Nishio S., Hirata Y. et al. Optimal analysis of left atrial strain by speckle tracking echocardiography: P-wave versus R-wave trigger. Echocardiography. 2015; 32 (8): 1241–9. DOI: 10.1111/echo.12834
  32. Yoon Y.E., Oh I.Y., Kim S.A., Park K.H., Kim S.H., Park J.H. et al. Echocardiographic predictors of progression to persistent or permanent atrial fibrillation in patients with paroxysmal atrial fibrillation (E6P Study). J. Am. Soc. Echocardiogr. 2015; 28 (6): 709–17. DOI: 10.1016/j.echo.2015.01.017
  33. Shih J.Y., Tsai W.C., Huang Y.Y., Liu Y.W., Lin C.C., Huang Y.S. et al. Association of decreased left atrial strain and strain rate with stroke in chronic atrial fibrillation. J. Am. Soc. Echocardiogr. 2011; 24 (5): 513–9. DOI: 10.1016/j.echo.2011.01.016 vHsu P.C., Lee W.H., Chu C.Y., Lee H.H., Lee C.S., Yen H.W. et al. Prognostic role of left atrial strain and its combination index with transmitral E-wave velocity in patients with atrial fibrillation. Sci. Rep. 2016; 6: 17318. DOI: 10.1038/srep17318
  34. Marrouche N.F., Wilber D., Hindricks G., Jais P., Akoum N., Marchlinski F. et al. Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study [published correction appears in JAMA. 2014; 312 (17): 1805]. JAMA. 2014; 311 (5): 498–506. DOI: 10.1001/jama.2014.3
  35. Kuppahally S.S., Akoum N., Badger T.J., Burgon N.S., Haslam T., Kholmovski E. et al. Echocardiographic left atrial reverse remodeling after catheter ablation of atrial fibrillation is predicted by preablation delayed enhancement of left atrium by magnetic resonance imaging. Am. Heart J. 2010; 160 (5): 877–84. DOI: 10.1016/j.ahj.2010.07.003
  36. Bockeria L.A., Golukhova E.Z., Kochladze N.G., Makarenko V.N., Aleksandrova S.A., Serov R.A. Prognostic and clinical significance of atrial remodeling markers in atrial fibrillation. Annaly Aritmologii (Annals of Arrhythmology). 2004; 1 (1): 71–7 (in Russ.)
  37. Golukhova E.Z., Bulaeva N.I. Atrial fibrillatoin in 2014: based on the updated guidelines АНА/АСС/HRS. Creative Cardiology. 2014; 3: 5–13 (in Russ.).
  38. Bockeria L.A., Revishvili A.Sh. Modern approaches to non-pharmacologica treatment of atrial fibrillation. Journal of Arrhythmology. 2006; 45: 5–16 (in Russ.).
  39. Calkins H., Kuck K.H., Cappato R., Brugada J., Camm A.J., Chen S.A. et al. 2012_HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012; 14 (4): 528–606. DOI: 10.1093/europace/eus027
  40. Zhuang J., Wang Y., Tang K., Li X., Peng W., Liang C. et al. Association between left atrial size and atrial fibrillation recurrence after single circumferential pulmonary vein isolation: a systematic review and meta-analysis of observational studies. Europace. 2012; 14: 638–45.
  41. Njoku A., Kannabhiran M., Arora R., Reddy P., Gopinathannair R., Lakkireddy D. et al. Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis. Europace. 2018; 20 (1): 33–42. DOI: 10.1093/europace/eux013
  42. Kohári M., Zado E., Marchlinski F.E., Callans D.J., Han Y. Left atrial volume best predicts recurrence after catheter ablation in patients with persistent and longstanding persistent atrial fibrillation. Pacing Clin. Electrophysiol. 2014; 37 (4): 422–9. DOI: 10.1111/pace.12279
  43. Mouselimis D., Tsarouchas A.S., Pagourelias E.D., Bakogiannis C., Theofilogiannakos E.K., Loutradis C. et al. Left atrial strain, intervendor variability, and atrial fibrillation recurrence after catheter ablation: A systematic review and meta-analysis. Hellenic J. Cardiol. 2020; 61 (3): 154–64. DOI: 10.1016/j.hjc.2020.04.008
  44. Itoh T., Kimura M., Tomita H., Sasaki S., Owada S., Horiuchi D. et al. Reduced residual conduction gaps and favourable outcome in contact forceguided circumferential pulmonary vein isolation. Europace. 2016; 18 (4): 531–7. DOI: 10.1093/europace/euv206
  45. De Potter T., Herendael H.V., Balasubramaniam R., Wright M., Agarwal S.C., Sanders P. et al. Safety and long-term effectiveness of paroxysmal atrial fibrillation ablation with a contact forcesensing catheter: real-world experience from a prospective, multicentre observational cohort registry. Europace. 2018; 20 (FI_3): f410–8. DOI: 10.1093/europace/eux290
  46. De Potter T., Herendael H.V., Balasubramaniam R., Wright M., Latcu D.G., Agarwal S.C. et al. , Safety and long-term success of persistent atrial fibrillation ablation using THERMOCOOL SMARTTOUCH® catheter: real-world experience. J. Atr. Fibrillation. 2019; 12 (2): 2126. DOI: 10.4022/jafib.2126

About Authors

  • Dzhamilya M. Mollaeva, Postgraduate
  • Tat'yana V. Mashina, Cand. Med., Senior Researcher Associate, Ultrasonic Diagnoctics Physician, ORCID
  • David V. Mrikaev, Cand. Med. Sc., Cardiologist, ORCID
  • Bektur Sh. Berdibekov, Postgraduate, ORCID
  • Andrey G. Filatov, Dr. Med. Sc., Professor, Head of Department, ORCID
  • Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of RAS, Director, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by