Impact of mitral regurgitation on left atrial appendage functions: the efficacy of speckle tracking echocardiography

We aimed to evaluate left atrial appendage functions (LAA) derived by speckle tracking echocardiography in patients with mild to severe mitral regurgitation (MR) and assess the relation between MR severity and LAA's anatomical, structural, and physiological functions.

Ninety-seven patients with mild, moderate, or severe MR admitted to our department for transesophageal echocardiography were included. In addition to conventional echocardiographic measurements, LAA functions were assessed by speckle tracking echocardiography. Patients were divided into three groups according to MR grades: mild MR, moderate MR, and severe MR.

The LAA reservoir, conduit, and contractile phase strain were lower in patients with moderate and severe MR than in those with mild MR. (10.0 ± 3.7 vs. 8.2 ± 3.5 vs. 16.7 ± 6.7, p < 0.001; 6.4 ± 3.0 vs. 4.9 ± 3.0 vs. 10.6 ± 4.9, p < 0.001; 3.6 ± 2.8 vs. 3.3 ± 2.1 vs. 6.1 ± 3, p < 0.001, respectively). Also, the LAA volume and area were significantly higher in the severe MR group. Spontaneous echo contrast was another factor associated with lower LAA strain parameters.

Hemodynamically important MR was associated with reduced LAA functions detected by speckle-tracking echocardiography. LAA strain may be used to predict the unfavorable effects of MR on LAA.