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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left atrium function by 2D speckle tracking in aortic valve disease.

Jose L Salas-Pacheco1, Nydia Ávila-Vanzzini1, Ruiz-Esparza M Eugenia1

  • 1Echocardiography Department, National Cardiologic Institute "Ignacio Chávez", México City, México.

Echocardiography (Mount Kisco, N.Y.)
|September 8, 2016
PubMed
Summary

Left atrial function is altered in aortic valve disease. Reduced reservoir strain is linked to pulmonary hypertension in patients with aortic stenosis or regurgitation.

Keywords:
aortic regurgitationaortic stenosisleft atriumpulmonary hypertension

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Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Physiology

Background:

  • Limited data exists on left atrial (LA) function in aortic valve stenosis (AS) or regurgitation (AR).
  • Two-dimensional speckle tracking echocardiography enables noninvasive assessment of LA functional disturbances in aortic valve disease.
  • These disturbances may impact the development of pulmonary hypertension (PH).

Purpose of the Study:

  • To investigate left atrial (LA) function using speckle tracking echocardiography in patients with aortic stenosis (AS) or regurgitation (AR).
  • To determine the association between LA functional parameters and the presence of pulmonary hypertension (PH).

Main Methods:

  • Consecutive patients with moderate or severe AS or AR underwent LA and left ventricle (LV) speckle tracking strain quantification.
  • 42 patients with AS and 30 with AR were included in the analysis.
  • Multivariable logistic regression was used to identify predictors of PH.

Main Results:

  • No significant differences in LA volumes and strain were observed between AS and AR groups.
  • LA volumetric derangements correlated with decreased LA longitudinal strain.
  • Higher LA volumes and reduced LA strain in conduit and reservoir phases were noted in severe valvular disease (SVD).
  • LA strain in the reservoir phase was significantly associated with PH (OR: 1.06, P=.01).

Conclusions:

  • Left atrial (LA) behavior is similar in patients with aortic stenosis (AS) and regurgitation (AR).
  • A strong correlation exists between LA volumetric and functional parameters.
  • LA strain during the reservoir phase is the primary variable associated with pulmonary hypertension (PH).