Echocardiographic markers for left atrial stiffness and left atrial conduction delay in patients with silent paroxysmal atrial fibrillation compared to age-matched controls.
7 affiliations
- 1Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Entrévägen 2, Stockholm, SE-182 88, Sweden. [email protected].
- 2Department Clinical Physiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden. [email protected].
- 3Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Entrévägen 2, Stockholm, SE-182 88, Sweden.
- 4Department of Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden.
- 5Department of Cardiology, Karolinska University Hospital, Stockholm, SE-171 76, Sweden.
- 6Department of Cardiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden.
- 7Department Clinical Physiology, Danderyd Hospital, Stockholm, SE-182 88, Sweden.
Abstract
Purpose
To 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
Individuals 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
Mean 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
Indices 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.
Related
- Unipolar electrogram-guided vs. ablation index-guided high-power short-duration pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a single-center randomized controlled trial
- Initiation of Glucagon-Like Peptide-1 Receptor Agonist Therapy and Lifestyle Modifications for Morbid Obesity in a Patient With Paroxysmal Atrial Fibrillation, Severe Osteoarthritis, and Obstructive Sleep Apnea: A Case Report
- Longitudinal Left Atrial Remodeling With Pharmacological Rhythm Versus Rate Control in Paroxysmal and Persistent Atrial Fibrillation
- Inferolateral ST-Segment Elevation Myocardial Infarction Secondary to Suspected Coronary Embolism in a Patient with Paroxysmal Atrial Fibrillation: A Case Report.
- Echocardiographic Assessment and Clinical Applications of the Left Atrial Stiffness Index in Cardiovascular Disease
BibTeX
@article{bastos2026echocardiographic,
title = {{Echocardiographic markers for left atrial stiffness and left atrial conduction delay in patients with silent paroxysmal atrial fibrillation compared to age-matched controls.}},
author = {Larissa Bastos and Faris Al-Khalili and Magnus Bäck and Aristomenis Manouras and Johan Engdahl and Kambiz Shahgaldi},
journal = {Cardiovascular ultrasound},
year = {2026},
month = oct,
doi = {10.1186/s12947-026-00395-1},
url = {https://europepmc.org/article/MED/42958262},
note = {CC BY},
}
RIS
TY - JOUR
TI - Echocardiographic markers for left atrial stiffness and left atrial conduction delay in patients with silent paroxysmal atrial fibrillation compared to age-matched controls.
AU - Larissa Bastos
AU - Faris Al-Khalili
AU - Magnus Bäck
AU - Aristomenis Manouras
AU - Johan Engdahl
AU - Kambiz Shahgaldi
PY - 2026
DA - 2026/10/28
JO - Cardiovascular ultrasound
DO - 10.1186/s12947-026-00395-1
UR - https://europepmc.org/article/MED/42958262
AB - Purpose To 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 Individuals 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 Mean 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 Indices 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.
SN - 1476-7120
ER -