Comorbidities compromise left, right atrial function

In patients with paroxysmal atrial fibrillation (AF), the presence of comorbidities is associated with lower left (LA) and right (RA) atrial strain, a recent study has found.

“In patients with few comorbidities, impairment in atrial function progresses during 1 year of follow-up. Whether comorbidity management prevents or reverses decrease in atrial function warrants further study,” the researchers said.

A total of 344 patients (mean age 58 years, 40 percent women) participated in the present cross-sectional analysis, all of whom underwent speckle-tracking echocardiography at baseline and 298 had available readings after 1 year of follow-up. Comorbidities included hypertension, diabetes mellitus, high body mass index (BMI), and coronary artery disease, among others.

Results showed that patients with more comorbidities had impaired LA and RA strain, an effect that appeared to be proportional with the number of comorbidities. LA volume index, on the other hand, was elevated in those with more comorbidities.

Logistic regression analysis, adjusted for atrial volumes, confirmed that having more comorbidities was strongly and significantly correlated with decreased strain parameters, particularly LA strain during the conduit phase (LAScd; odds ratio per 1-percent LAScd decrease, 0.92, 95 percent confidence interval, 0.88–0.96).

Of note, patients with one to two comorbidities, but not those with three or more, showed a further drop in LA and RA strain parameters at almost all phases at the 14-month follow-up visit.