Pernigo M, et al. - The role of preoperative left atrial longitudinal strain as an indicator of postoperative atrial fibrillation (POAF) in clinical practice is tested in this study. The current study showed that the Peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) indexes are routinely feasible and valuable to predict POAF in patients with severe isolated aortic stenosis undergoing surgical aortic valve replacement.

Methods

• In this study, total 60 patients scheduled for aortic valve replacement for severe isolated aortic stenosis, in stable sinus rhythm, were prospectively enlisted and underwent full clinical, biochemical, and transthoracic echocardiographic assessment on the day before surgery.
• Left atrial strain-derived peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) were obtained.
• The occurrence of POAF was assessed amid the hospital stay after the intervention.

Results

• Among these 60 patients, POAF was present in 26 (43.3%).
• Among all clinical variables examined, age showed a significant correlation with POAF (P = .04), while no significant differences were observed in regards to preoperative symptoms, cardiovascular risk factors, medications, and biochemical information.
• As for the echocardiographic parameters, only PALS and PACS exhibited strong, significant correlations with the occurrence of arrhythmia (P < .0001 on univariate analysis), with areas under the curve of 0.87 ± 0.04 (95% CI, 0.76-0.94) for PALS and 0.85 ± 0.05 (95% CI, 0.73-0.93) for PACS.
• In two comprehensive multivariate models, PALS and PACS remained significant predictors of POAF (odds ratio, 0.73 [95% CI, 0.61-0.88; P = .0008] and 0.72 [95% CI, 0.59-0.87; P = .0007]).
• There was no significant interaction detected between PALS or PACS and other clinical and echocardiographic variables, including age, E/E' ratio, and left atrial enlargement.