@article{article_1652473, title={Left atrial appendage strain and P-wave dispersion: electro-mechanical markers of paroxysmal atrial fibrillation}, journal={Journal of Medicine and Palliative Care}, volume={6}, pages={199–206}, year={2025}, DOI={10.47582/jompac.1652473}, author={Demirtola, Ayşe İrem and İnan, Duygu and Mammadli, Anar and Özkan, Eyüp and Balaban, İsmail and Akbulut, İrem Müge and Akgün, Hüseyin and Acar, Gamze and Çolak, Gülnur and Güler, Ahmet and et al.}, keywords={Atrial fibrillation, left atrial appendage, transesophageal echocardiography, electrocardiography, prediction algorithms}, abstract={Aims: Paroxysmal atrial fibrillation (PAF) is a major clinical challenge due to its intermittent nature and the difficulty of early detection. Left atrial appendage (LAA) function plays a crucial role in atrial mechanics, while P-wave dispersion (PWD) reflects electrical inhomogeneity. We hypothesized that both parameters would independently and synergistically predict PAF and aimed to develop an integrative electro-mechanical model to enhance risk stratification. Methods: We retrospectively analyzed 191 patients, including 91 with PAF and 100 in sinus rhythm (SR). LAA function was assessed using speckle-tracking echocardiography, and PWD was measured digitally from 12-lead electrocardiography. Multivariable logistic regression models were constructed: model 1 included clinical parameters, model 2 incorporated PWD, and Model 3 further added LAA strain reservoir (LAA-Sr) Results: PAF patients exhibited significantly lower LAA-Sr (14.7 % [12.2-18.0] vs. 21.6% [19.1-25.3], p <0.001) and higher PWD (30.3 [27.6-34.5] ms vs. 20.9 [17.3-26.6] ms, p <0.001). In multivariable analysis, LAA-Sr (OR: 1.315, 95% confidence interval [CI]: 1.201-1.439, p <0.001) and PWD (OR: 1.128, 95% CI: 1.054-1.215, p=0.038) were independent PAF predictors. Model 3, which included both parameters, demonstrated the best predictive performance (AUC: 0.983, sensitivity: 92.8%, specificity: 79.4%) compared to model 1 (AUC: 0.890) and model 2 (AUC: 0.950). Conclusion: Our study highlights LAA strain and PWD as robust, independent predictors of PAF. The combination of mechanical and electrophysiological markers enhances AF risk stratification and early detection. Future prospective, multicenter studies are warranted to validate these findings and optimize risk assessment strategies for PAF.}, number={3}, publisher={MediHealth Academy Yayıncılık}, organization={None}