Peak Atrial Longitudinal Strain sebagai Prediktor Kejadian Fibrilasi Atrium pada Pasien Gagal Jantung dengan Sinus Ritme di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Introduction: A complication that can arise from heart failure and is a part of major cardiovascular event is atrial fibrillation. One method that can be used to predict the incidence of atrial fibrillation is by using echocardiography. The overall myocardial load is based on the speckle-tracking method and measures myocardial deformity directly which then reflects myocardial contractility. Alterations in the anatomy and physiology of the left atrium have been identified as predictors of atrial fibrillation. Objective: To determine the ability of echocardiographic parameters of Peak Atrial Longitudinal Strain as a predictor of atrial fibrillation in heart failure patients with sinus rhythm Method: This study is an analytic observational study conducted as a retrospective cohort on 100 samples with a diagnosis of heart failure, sine wave EKG results, and a good echocardiographic view. An analysis was performed to obtain a calculation of Peak Atrial Longitudinal Strain and other echocardiographic parameters. Data were analyzed univariately, bivariately, and multivariately using the ROC curve to assess the predictive ability of Peak Atrial Longitudinal Strain. Result: Of the 100 study samples, 29 patients (29%) had atrial fibrillation. PALS parameters were found to decrease significantly in patients who later developed AF compared with patients who did not develop AF. The results of the ROC analysis showed that the PALS value was a very strong predictor of the incidence of AF (AUC: 0.850, 95% CI: 0.757-0.943, p=0.001) with a cut-off value of 18. It was found that there were 38% of patients with a PALS value of ≤18, there were 62 % of patients with PALS values >18. There is a statistically significant relationship between the PALS value and the incidence of atrial fibrillation (p=0.001). Conclusion: PALS value can be used as a predictor of FA during treatment in heart failure patients.