Left atrium function by 2D speckle tracking in aortic valve disease

A paucity of data exists about left atrium (LA) function in aortic valve stenosis (AS) or regurgitation (AR). Two-dimensional speckle tracking echocardiography allows the noninvasive study of LA functional disturbances in aortic valve disease and their impact in the development of pulmonary hypertension (PH).

Consecutive patients with moderate or severe AS or AR were included. Left ventricle (LV) and LA speckle tracking strain quantification was performed. We included 42 patients with AS and 30 with AR. Differences were not found in LA volumes and strain in AS or AR. The LA volumetric derangements parallel the decrease in LA longitudinal strain. Maximum LA volume, minimum LA volume, and indexed LA volume were higher in severe valvular disease (SVD) than in moderate [23 cc (P=.018, IC_95% : 4-41), 16 cc (P=.035, IC_95% : 2-31), and 14 cc (P=.022, IC_95% : 2-25), respectively], occurred in the same way with LA strain in the conduit (6.3%, P=.034, IC_95% : 1-12) and reservoir (7.1%, P=.04, IC_95% : 2-14) phases. In multivariable model, strain of reservoir phase was the variable mainly associated with PH; each decrease in one unit of strain of reservoir phase increased 6% the PH probability (OR: 1.06, P=.01).

This study demonstrates that in patients with AS and AR, the LA has a similar behavior and that exist a close correlation between LA volumetric and functional parameters. The variable mainly associated with PH was LA strain of reservoir phase.