Left Atrial Strain Values as an Early Predictor of Atrial Fibrillation
Research type
Research Study
Full title
Can left atrial strain measurements, and correlating changes in left atrium area and volume size, be used as an early predictor of atrial fibrillation?
IRAS ID
324893
Contact name
Lucy Hwozdyk
Contact email
Sponsor organisation
Hywel Dda University Health Board
Duration of Study in the UK
0 years, 10 months, 31 days
Research summary
Atrial fibrillation (AF) is the most common type of abnormal heart rhythm. This occurs as the chambers of the heart pump irregularly, often resulting in a fast heart rate and symptoms of irregular pounding and fluttering. There are many risk factors predisposing to AF, however, the cause cannot always be easily determined. Additionally, not all AF patients experience symptoms and consequently, this abnormal rhythm may go undetected and may be discovered accidentally. This is detrimental to patients, as untreated AF patients are at an increased risk of stroke.
Patients that are suspected to have AF are referred for an ultrasound scan of the heart (echocardiogram). It is expected to see structural changes to the heart's chambers. However, structural and electrical changes of the heart may be the cause of AF but may also be a result of AF; resulting in a chicken and egg situation. It may be possible that a different type of measurement can be used during an echocardiogram to detect subtle changes in heart muscle patterns. This measurement may then serve to be an early predictor of AF. This would be determined by comparing the patterns in patients with a normal, regular rhythm to those with AF.
Potential candidates will initially be screened based on their echocardiogram referral. If deemed eligible, the patient will be sent the PIS, ICF and an invitation letter in the post. The echocardiogram will be performed as normal with a focus on the area and volume measurements taken of one of the top chambers of the heart. An additional measurement will be taken to observe any subtle changes in the arrangement of heart cells within this same heart chamber. These measurements can be compared to each other to establish any relationship as well as compared to patients with and without AF.
Lay summary of study results: Atrial fibrillation (AF) is the most common type of abnormal heart rhythm within the adult population. This is often characterised by a fast, irregular heart rate and rhythm. On a heart scan (transthoracic echocardiogram), it is expected that patients with AF have a larger and / or dilated left atrium (LA). LA strain analysis is able to detect subtle changes within the LA before dilatation occurs.Left atrial (LA) strain values were compared across three groups: normal sinus rhythm and normal blood pressure, normal sinus rhythm and high blood pressure and known AF. Three types of strain values were produced: reservoir (LASr), conduit (LAScd) and contractile (LASct) strain. It was found that there were statistically significant differences in LASr across the three groups, as patients with AF had significantly lower LASr values.
Furthermore, the correlation between LASr and LA area and volume size was also investigated. A significantly moderate negative correlation was seen between LASr and LA area size and also between LASr and LA volume size. This suggests that as LASr values decrease, the LA size increases.
Furthermore, the possibility for LASr to act as an early predictor for AF development and progression was also investigated. It was found that as LASr values decrease, the likelihood of developing AF / AF progression increases by 0.38 to 0.72 points.
Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: Results have only recently been collected and awaiting MSc dissertation marking.The registry will be updated in due course with the study results. Results should be available on the accessible register by 30/06/2024.
The registry will be updated in due course with the study results. Results should be available on the accessible register by 30/06/2024.REC name
London - Queen Square Research Ethics Committee
REC reference
23/PR/0340
Date of REC Opinion
20 Jun 2023
REC opinion
Further Information Favourable Opinion