Quantitative Assessment of Left Ventricular Myocardial Work in Patients
with Different Types of Atrial Fibrillation by Non-invasive
Pressure-strain Loop Technique
Abstract
Objective: This study aimed to analyze myocardial work in patients with
atrial fibrillation (AF) using a non-invasive pressure strain loop (PSL)
technique to provide a basis for the quantitative assessment of left
ventricular (LV) systolic function. Methods: LV myocardial
work of 107 AF patients and 55 healthy individuals was assessed by the
non-invasive PSL and then compared. Results: Global
longitudinal strain (GLS) in absolute values, global work index (GWI),
global constructive work (GCW), and global work efficiency (GWE) were
significantly lower in the AF group than control group, whereas peak
strain dispersion (PSD) and global wasted work (GWW) were significantly
higher ( P<0.05). Further subdivision according to the
AF type revealed that, compared with the controls, GLS in absolute
values and GWE decreased significantly; PSD and GWW increased
significantly in the paroxysmal AF group ( P<0.05).
Compared to paroxysmal AF, persistent AF induced a further decrease in
absolute GLS and GWE and a further increase in GWW (
P<0.05) . Multiple linear regression analysis showed
that GWI and GCW were associated with systolic blood pressure. GWW was
associated with types of AF and left atrial volume index (LAVI). GWE was
correlated with age, types of AF, disease duration, and LAVI. Receiver
operating characteristic curve analysis showed that the area under the
curve predicting myocardial injury was higher for GWE and GWW than for
GLS. Conclusions: Non-invasive PSL can quantitatively assess LV
systolic function in patients with different kinds of AF and detect
early subclinical myocardial injury in patients with paroxysmal AF.
Systolic blood pressure, type of AF, LVAI, disease duration, and age may
be associated with myocardial injury in patients with AF.