Spartera M, Stracquadanio A, Pessoa-Amorim G, et al. - Irrespective of a history of atrial fibrillation (AF), altered left atrial (LA) flow characteristics in sinus rhythm (SR) were evident in association with an LA myopathic phenotype and left ventricular (LV) diastolic dysfunction, among patients carrying a moderate-to-high stroke risk.

• This study involved 95 persons: 37 having persistent AF were examined before and post-cardioversion [Group 1; median CHA ₂ DS ₂ -VASc = 2.0]; 35 persons with no history of AF but similar stroke risk to Group 1 [Group 2; median CHA ₂ DS ₂ -VASc = 3.0]; and 23 low-risk people in SR [Group 3; median CHA ₂ DS ₂ -VASc = 0.0].

• Pre-cardioversion, impaired LV and LA function, decreased LA flow velocities and vorticity, and a higher normalized vortex volume were seen in Group 1.

• Following restoration of SR at ≥4-week after cardioversion, significant improvement was evident in LV systolic function and LA flow parameters and they were no longer different from those in Group 2.

• However, when SR was present, LA flow peak and mean velocity, and vorticity were lower in Groups 1 and 2 compared with Group 3, and were related to impaired LA emptying fraction and LV diastolic dysfunction.