Correlation between Peak Left Atrial Longitudinal Strain and The Severity of Mitral Valve Disease at Haji Adam Malik General Hospital Medan
Abstract
Introduction: Mitral stenosis and regurgitation, are common throughout the world. Peak Left Atrial Strain (PALS) is a parameter for assessing left atrial deformation in the evaluation of atrial function and a predictor of long-term outcome of various heart diseases. In this study, we assessed the relationship between PALS and the severity of mitral stenosis and mitral regurgitation
Methods: This is a cross-sectional study on 119 subjects with mitral stenosis and 103 mitral regurgitation who met the inclusion criteria at Haji Adam Malik General Hospital. PALS measurements were taken. Data were analyzed univariate, bivariate, correlate to assess the relationship between PALS and the severity of mitral valve disease
Results: 119 patients with severe mitral stenosis. In mitral stenosis, the mean PALS is 8.2 (4.9-22.8). PALS was significantly higher in patients with sinus rhythm than in the group with AF (10.29 ± 3.89 vs 8.63 ± 7.8%; P = 0.002). PALS had a significant correlation with MVA, pressure gradient, and PHT (r = 0.676, P = <0.001; r=-0.594, P= 0.001 and r=-0.594, P= 0.001). Whereas in mitral regurgitation, it has an average PALS of 15.2 (7.8-19.2). PALS was also significantly higher in patients with sinus rhythm than in the group with AF (16.36 ± 2.43 vs 11.64 ± 2.89%, P = 0.001). PALS has a correlation with VC, PISA, EROA and RVol (r = -0.533, P=0.001; r=-0.618; r=-0.563, P=0.001; r= -0.528, P=0.001).
Conclusion: PALS has a significant correlation with the assessment of the severity of mitral stenosis and regurgitation.
Downloads
References
2. Shah S, Sharma S. Mitral Stenosis. https://www.ncbi.nlm.nih.gov/books/NBK430742/. 2022.
3. Pastore MC, Mandoli GE, Dokollari A, Bisleri G, D’Ascenzi F, Santoro C, et al. Speckle tracking echocardiography in primary mitral regurgitation: should we reconsider the time for intervention? Heart Fail Rev. 2022 Jul 7;27(4):1247–60.
4. Dziadzko V, Clavel MA, Dziadzko M, Medina-Inojosa JR, Michelena H, Maalouf J, et al. Outcome and undertreatment of mitral regurgitation: a community cohort study. The Lancet. 2018 Mar;391(10124):960–9.
5. Koencoro AS. Pemeriksaan Stenosis Mitral Akibat Proses Rheumatik Dengan Ekokardiografi. Indonesia Journal of Cardiology. 2010;31(1).
6. Mehta V, Chaudhari D, Mehra P, Mahajan S, Yusuf J, Gupta MD, et al. Left atrial function by two-dimensional speckle tracking echocardiography in patients with severe rheumatic mitral stenosis and pulmonary hypertension. Indian Heart J. 2022 Jan;74(1):63–5.
7. Castro FA, Azevedo O, Lourenco M, Faria B, Oliveira I, Lourenco A. Evaluation of left atrial strain in patients with rheumatic mitral stenosis. European Heart Journal Supplements. 2017.
8. Mahfouz RA, Gouda M, Abdelhamed M. Relation between left atrial strain and exercise tolerance in patients with mild mitral stenosis: An insight from 2D speckle-tracking echocardiography. Echocardiography. 2020 Sep 1;37(9):1406–12.
9. Shojaeifard M, Firouzi A, Sanati HR, Mohebbi B, Saedi S, Moradian M. Decreased Systolic Left Atrial Strain Measures Correlate With the Valve Area Among Patients With Severe Mitral Stenosis. Iranian Heart Journal. 2020;20(2).
10. Rohani A, Kargar S, Fazlinejad A, Ghaderi F, Vakili V, Falsoleiman H, et al. Acute effect of treatment of mitral stenosis on left atrium function. Ann Card Anaesth. 2017;20(1):42.
11. Vriz O, Feras K, Alamri M, Blassy B, Almozel A, Smith M, et al. Severe rheumatic mitral stenosis, worse left atrial mechanics is closely associated with echo criteria for intervention. J Cardiovasc Echogr. 2022 Jan 1;32(1):38–46.
12. Stassen J, Butcher SC, Namazi F, Ajmone Marsan N, Bax JJ, Delgado V. Left Atrial Deformation Imaging and Atrial Fibrillation in Patients with Rheumatic Mitral Stenosis. Journal of the American Society of Echocardiography. 2022 May 1;35(5):486-494.e2.
13. Lisi M, Cameli M, Di Tommaso C, Curci V, Reccia R, D’ascenzi F, et al. Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair. Journal of Clinical Ultrasound. 2018 Jan 1;46(1):32–40.
14. Cameli M, Lisi M, Righini FM, Focardi M, Alfieri O, Mondillo S. Left atrial speckle tracking analysis in patients with mitral insufficiency and history of paroxysmal atrial fibrillation. Int J Cardiovasc Imaging. 2012 Oct 1;28(7):1663–70.
15. Stassen J, Van Wijngaarden AL, Butcher SC, Palmen M, Herbots L, Bax JJ, et al. Prognostic value of left atrial reservoir function in patients with severe primary mitral regurgitation undergoing mitral valve repair. Eur Heart J Cardiovasc Imaging. 2023 Jan 1;24(1):142–51.
16. Cameli M, Incampo E, Mondillo S. Left atrial deformation: Useful index for early detection of cardiac damage in chronic mitral regurgitation. IJC Heart & Vasculature. 2017 Dec;17:17–22.
17. Candan O, Ozdemir N, Aung SM, Hatipoglu S, Karabay CY, Guler A, et al. Atrial longitudinal strain parameters predict left atrial reverse remodeling after mitral valve surgery: a speckle tracking echocardiography study. Int J Cardiovasc Imaging. 2014 Aug 30;30(6):1049–56.
18. Messika-Zeitoun D, Bellamy M, Avierinos JF, Breen J, Eusemann C, Rossi A, et al. Left atrial remodelling in mitral regurgitation--methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study. Eur Heart J. 2007 Mar 6;28(14):1773–81.
FULLTEXT (PDF) downloads: 494
Copyright (c) 2024 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).