{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:28:34Z","timestamp":1766579314711,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italiana di Ecocardiografia e Cardiovascular Imaging (SIECVI)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. Aim: This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. Methods: In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 \u00b1 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. Results: LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 \u00b1 12.2, Group 2 = 31.6 \u00b1 12.9, Group 3 = 43.3 \u00b1 19.7 mL\/m2, p &lt; 0.001) and at peak stress (Group 1 = 26.2 \u00b1 12.0, Group 2 = 31.2 \u00b1 12.2, Group 3 = 43.9 \u00b1 19.4 mL\/m2, p &lt; 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 \u00b1 8.5%, Group 2 = 23.2 \u00b1 11.2%, Group 3 = 8.5 \u00b1 6.5%, p &lt; 0.001) and at peak stress (Group 1 = 26.9 \u00b1 10.1, Group 2 = 23.8 \u00b1 11.0 Group 3 = 10.7 \u00b1 8.1%, p &lt; 0.001). Stress B-lines (\u22652) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p &lt; 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). Conclusions: In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.<\/jats:p>","DOI":"10.3390\/jcm12185893","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T09:11:18Z","timestamp":1694423478000},"page":"5893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rest and Stress Left Atrial Dysfunction in Patients with Atrial Fibrillation"],"prefix":"10.3390","volume":"12","author":[{"given":"Angela","family":"Zagatina","sequence":"first","affiliation":[{"name":"Cardiology Department, Research Scientific Cardiocenter \u201cMedika\u201d, 197110 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rivadeneira Ruiz","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital of Virgen Macarena, 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-8380","authenticated-orcid":false,"given":"Quirino","family":"Ciampi","sequence":"additional","affiliation":[{"name":"Fatebenefratelli Hospital of Benevento, 82100 Benevento, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7623-5389","authenticated-orcid":false,"given":"Karina","family":"Wierzbowska-Drabik","sequence":"additional","affiliation":[{"name":"Department of Internal Disease and Clinical Pharmacology, Medical University, 93-510 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5850-8187","authenticated-orcid":false,"given":"Jaroslaw","family":"Kasprzak","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bieganski Hospital, Medical University, 93-510 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Kalinina","sequence":"additional","affiliation":[{"name":"Cardiology Department, Research Scientific Cardiocenter \u201cMedika\u201d, 197110 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Begidova","sequence":"additional","affiliation":[{"name":"Cardiology Department, Research Scientific Cardiocenter \u201cMedika\u201d, 197110 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8457-6351","authenticated-orcid":false,"given":"Jesus","family":"Peteiro","sequence":"additional","affiliation":[{"name":"CHUAC\u2014Complexo Hospitalario Universitario A Coruna, University of A Coruna, 15071 La Coruna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0652-3913","authenticated-orcid":false,"given":"Rosina","family":"Arbucci","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Marconi","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6009-0253","authenticated-orcid":false,"given":"Alla","family":"Boshchenko","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, 634028 Tomsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiore","family":"Manganelli","sequence":"additional","affiliation":[{"name":"Cardiology Department, SG Moscati Hospital, 83100 Avellino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"\u010celutkien\u0117","sequence":"additional","affiliation":[{"name":"Centre of Cardiology and Angiology, Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Centre of Innovative Medicine, LT-10257 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doralisa","family":"Morrone","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7689-1167","authenticated-orcid":false,"given":"Elisa","family":"Merli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale per gli Infermi, Faenza, 48100 Ravenna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Re","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale San Camillo, 00149 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3843-9049","authenticated-orcid":false,"given":"Clarissa","family":"Borguezan-Daros","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital San Jos\u00e9, Criciuma 88801-250, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Haberka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, SHS, Medical University of Silesia, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6495-997X","authenticated-orcid":false,"given":"Ariel K.","family":"Saad","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Cardiolog\u00eda, Hospital de Cl\u00ednicas Jos\u00e9 de San Mart\u00edn, Buenos Aires C1120, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2359-5192","authenticated-orcid":false,"given":"Ana","family":"Djordjevic-Dikic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Center Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nithima Chaowalit","family":"Ratanasit","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Rigo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dolo Hospital, 30031 Venice, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Colonna","sequence":"additional","affiliation":[{"name":"Cardiology Division, Bari University Hospital, 70100 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-2753","authenticated-orcid":false,"given":"Jos\u00e9 Luis de Castro e Silva","family":"Pretto","sequence":"additional","affiliation":[{"name":"Hospital Sao Vicente de Paulo e Hospital de Cidade, Passo Fundo 99010-080, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Mori","sequence":"additional","affiliation":[{"name":"SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, 50139 Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"D\u2019Alfonso","sequence":"additional","affiliation":[{"name":"SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, 50139 Firenze, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miodrag","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2219-7679","authenticated-orcid":false,"given":"Bojan","family":"Stanetic","sequence":"additional","affiliation":[{"name":"Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7100-5189","authenticated-orcid":false,"given":"Tamara Kovacevic","family":"Preradovic","sequence":"additional","affiliation":[{"name":"Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Costantino","sequence":"additional","affiliation":[{"name":"Cardiology Division, San Carlo Hospital, 85100 Potenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-9602","authenticated-orcid":false,"given":"Andrea","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7796-6298","authenticated-orcid":false,"given":"Rodolfo","family":"Citro","sequence":"additional","affiliation":[{"name":"Cardiology Division, Ospedale Ruggi di Aragona, 84100 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Pitino","sequence":"additional","affiliation":[{"name":"CNR, Institute of Clinical Physiology, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2524-6288","authenticated-orcid":false,"given":"Mauro","family":"Pepi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS, 20138 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scipione","family":"Carerj","sequence":"additional","affiliation":[{"name":"Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, 98166 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-3521","authenticated-orcid":false,"given":"Patricia A.","family":"Pellikka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6375-6361","authenticated-orcid":false,"given":"Eugenio","family":"Picano","sequence":"additional","affiliation":[{"name":"CNR, Institute of Clinical Physiology, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic 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