{
  "abstract": "Purpose\n\nTo study left atrial stiffness index (LASI) and left atrial activation time (LA-AT) changes in an older population with silent paroxysmal atrial fibrillation (PAF) compared to age-matched control.Methods\n\nIndividuals with newly diagnosed PAF and a randomly selected age-matched control group without AF were enrolled from STROKESTOP2-study. All participants had NT-proBNP levels 125-900 ng/L. TTE examinations were analyzed retrospectively offline using dedicated software. Besides conventional echocardiographic measurements, LA-AT was obtained by measuring the time delay between the onset of the P-wave on ECG and tissue Doppler Á peak wave in lateral LA wall. LASI was calculated as the ratio of left ventricular filling (E/é) to peak atrial longitudinal strain (PALS).Results\n\nMean age was 76 ± 0.3 years. The PAF group (n = 67) presented significant increase of LASI (0.41 (0.29-0.60) vs. 0.32 (0.29-0.43), P = 0.001) and prolonged LA-AT (170 (140-180) ms vs. 140 (120-144) ms, P < 0.001) compared to controls (n = 94). Subgroup analysis in participants with normal LA volume index (LAVI) ≤ 34 ml/m², LASI and LA-AT remained significantly increased/prolonged in PAF (N = 27) compared to controls (N = 72). NT-proBNP-levels did not differ between PAF (228 (181-348) ng/L) and controls (216 (156-317) ng/L) (P = 0.18). ROC curve analysis identified thresholds LASI > 0.54 and LA-AT > 139 msec for discrimination of silent PAF.Conclusion\n\nIndices reflecting LA stiffness and atrial conduction delay were significantly elevated in recently diagnosed PAF patients. LASI and LA-AT thresholds might non-invasively detect early atrial remodeling without structural enlargement in elderly patients with high risk of PAF and mildly increased NT-proBNP levels.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Entrévägen 2, Stockholm, SE-182 88, Sweden. larissa.bastos@ki.se.",
    "Department Clinical Physiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden. larissa.bastos@ki.se.",
    "Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Entrévägen 2, Stockholm, SE-182 88, Sweden.",
    "Department of Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden.",
    "Department of Cardiology, Karolinska University Hospital, Stockholm, SE-171 76, Sweden.",
    "Department of Cardiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden.",
    "Department Clinical Physiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Larissa Bastos",
      "orcid": "0000-0001-7767-4159"
    },
    {
      "affs": [
        2
      ],
      "name": "Faris Al-Khalili",
      "orcid": "0000-0002-8849-7052"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Magnus Bäck",
      "orcid": "0000-0003-0853-5141"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Aristomenis Manouras",
      "orcid": "0000-0002-6617-2070"
    },
    {
      "affs": [
        2,
        5
      ],
      "name": "Johan Engdahl",
      "orcid": "0000-0002-1677-7215"
    },
    {
      "affs": [
        2,
        6
      ],
      "name": "Kambiz Shahgaldi",
      "orcid": "0000-0001-9677-8252"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/09vsxq6eevmbm.bib",
  "cited_by": 0,
  "doi": "10.1186/s12947-026-00395-1",
  "fulltext_url": "https://europepmc.org/articles/PMC13721264",
  "id": "09vsxq6eevmbm",
  "issns": [
    "1476-7120"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958262",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7224121280",
  "pdf_url": "https://europepmc.org/articles/PMC13721264?pdf=render",
  "pmcid": "PMC13721264",
  "pmid": "42958262",
  "published": "2026-10-28",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/09vsxq6eevmbm.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:36Z",
      "native_id": "MED:42958262",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958262"
    },
    {
      "first_seen": "2026-11-03T12:21:59Z",
      "native_id": "PMC13721264",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12947-026-00395-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Echocardiographic markers for left atrial stiffness and left atrial conduction delay in patients with silent paroxysmal atrial fibrillation compared to age-matched controls.",
  "title_text": "Echocardiographic markers for left atrial stiffness and left atrial conduction delay in patients with silent paroxysmal atrial fibrillation compared to age-matched controls.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:59Z",
  "url": "https://research.draconitic.com/paper/09vsxq6eevmbm",
  "venue": "Cardiovascular ultrasound",
  "versions": []
}