Left atrial mechanical functions in chronic primary mitral regurgitation patients: a velocity vector imaging-based...

Assessment of the left atrium (LA) mechanical function provides further information on the level of cardiac compensation. We aimed to evaluate LA function using a strain imaging method: velocity vector imaging (VVI) in chronic primary mitral regurgitation (MR).

We recruited 48 patients with chronic, isolated, moderate to severe MR (54.70 ±15.35 years and 56% male) and 30 age- and sex-matched healthy controls (56.52 ±15.95 years and 56% male). The LA volumes during reservoir (RV), conduit (CV) and contractile phases (AV) were measured. Global strain (S), systolic strain rate (SRs), early diastolic (ESRd) and late diastolic strain rate (LSRd) were calculated.

LA RV (50 ±18.7 to 37.9 ±5.9; p = 0.0001), CV (43.1 ±29 to 21 ±2.56; p = 0.0001), and AV (17.9 ±13.5 to 10.9 ±1.9; p = 0.006) were increased in MR patients. The LA reservoir phase strain was 16.2 ±8.1% in the MR group and 51.1 ±5.7% in the control group (p = 0.0001). The LA SRs (1.01 ±0.52 s(-1) for MR and 2.1 ±0.22 s(-1) for controls; p = 0.0001), LA ESRd (0.83 ±0.34 s(-1) for MR and 2.26 ±0.17 s(-1) for controls; p = 0.0001) and LA LSRd (0.76 ±0.24 s(-1) for MR and 2.2 ±0.26 s(-1) for controls; p = 0.0001) were impaired in MR patients.

The LA deformation indices may be used as adjunctive parameters to determine LA dysfunction in chronic primary MR.