Atrial Longitudinal Strain Predicts New-Onset Atrial Fibrillation: A Systematic Review and Meta-Analysis

This study focuses on the role of left atrial longitudinal strain (LAS) in predicting new-onset atrial fibrillation (NOAF). LAS, assessed via speckle-tracking echocardiography, evaluates atrial function through three phases: reservoir, conduit, and contraction. A systematic review and meta-analysis were conducted, including 12 studies and 5,074 patients. The analysis found that LASr, the reservoir phase, significantly predicts NOAF, with a pooled hazard ratio (HR) of 0.96 for each 1% decrease in LASr. LASr was an independent predictor of NOAF in various patient groups, including those with heart failure, ischemic stroke, and chronic obstructive pulmonary disease. The study concludes that LASr is a reliable tool for predicting NOAF and should be part of routine echocardiographic evaluations in high-risk patients. However, the study acknowledges some limitations, including variability in the covariate adjustments across studies.