Abstract 16418: The Impact of MitraClip® Procedure on Left Atrial Strain and Strain Rate

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Esra Gucuk Ipek ◽  
Atif Qasim ◽  
Esperanza Viloria ◽  
Ted Feldman ◽  
Paul A Grayburn ◽  
...  
Keyword(s):  
Strain Rate ◽  
Left Atrial ◽  
Atrial Remodeling ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
One Year ◽  
Atrial Strain ◽  
The Impact ◽  
Strain Measures

Background: Left atrial (LA) remodeling due to mitral regurgitation (MR) is associated with abnormal LA strain parameters which may correlate with degree of fibrosis. Although reverse atrial remodeling has been shown after MitraClip placement, changes in LA strain and strain rate have not been evaluated in these patients or compared with mitral valve repair (MVr). Methods: We measured peak positive LA strain (ε) and strain rates [peak systolic (SRp), peak early diastolic (SRe) and peak late diastolic (SRa)] in 107 subjects (mean age 61±12 yrs) with degenerative MR enrolled in the randomized EVEREST II trial. Individuals with paced rhythm, atrial fibrillation, functional MR and poor image quality were excluded. LA strain measures were obtained from 4-chamber and 2-chamber views and averaged at baseline and at 1 year follow up. Results: At one year all 44 MVr subjects had ≤2+ MR, whereas 22 of the 63 MitraClip had >2+ MR. Baseline average ε, SRp, SRe and SRa values were similar in MitraClip and MVr groups (Table 1). At one year follow up there was a significant decrease in LA volumes in the surgical group and in those with MR ≤2+ after MitraClip. Overall average ε was significantly reduced after MVr. There was a small decrease or no change in average ε after MitraClip. SRe was significantly decreased 1 year after MVr and also in the MitraClip arm, regardless of whether there was significant MR reduction. There were no changes in SRp and SRa at 1 year in either group. Conclusion: Average peak positive LA strain either decreased modestly or did not change after treatment of MR in chronic degenerative MR subjects. There was a significant decrease in SRe in both treatment arms at 1 year. This occurred despite evidence of reverse LA remodeling. Further investigation and replication in additional cohorts is needed to explore these findings, which may suggest persistence of LA dysfunction after correction of chronic MR, or irreversible fibrosis. Disclosure: EVEREST II was funded by Abbott Vascular.

scholarly journals Do left atrial strain and strain rate reflect intrinsic atrial function, or are they determined by left ventricular function?

2015 ◽  
pp. 539-548 ◽  
Author(s):  
Andrei Dumitru Margulescu ◽  
Emma Rees ◽  
Rose-Marie Coulson ◽  
Aled D. Rees ◽  
Dragos Vinereanu ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Strain Rate ◽  
Ventricular Function ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

scholarly journals ASSOCIATION OF DECREASED LEFT ATRIAL STRAIN AND STRAIN RATE WITH STROKE IN CHRONIC ATRIAL FIBRILLATION

2010 ◽  
Vol 55 (10) ◽  
pp. A93.E879
Author(s):  
Jhih-Yuan Shih ◽  
Wei-Chuan Tsai ◽  
Yao-Yi Huang ◽  
Yen-Wen Liu ◽  
Chih-Chan Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Strain Rate ◽  
Left Atrial ◽  
Chronic Atrial Fibrillation ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

Abstract 5664: Left Atrial Strain In Patients With Atrial Fibrillation: Relationship To Fibrosis By Delayed Enhancement-MRI

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Suman S Kuppahally ◽  
Robert S Oakes ◽  
Eric N Fish ◽  
Eugene Kholmovski ◽  
Sathya Vijayakumar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Strain Rate ◽  
Left Atrial ◽  
Delayed Enhancement ◽  
Left Atrial Strain ◽  
Chamber View ◽  
Strain And Strain Rate ◽  
Procedural Success ◽  
Atrial Strain

Introduction: The extent of left atrial (LA) wall fibrosis detected by delayed enhancement (DE)-cardiac MRI prior to catheter ablation of atrial fibrillation (AF) appears to predict procedural success. However, it is currently unknown how the degree of fibrosis affects atrial mechanical function. Methods: Prior to catheter ablation of AF, 31 patients underwent DE-CMRI and 2-dimensional transthoracic echocardiography. 3D segmentation of LA was performed and the degree of fibrosis was determined using a semi-automated quantification algorithm. Longitudinal mid-septal and mid-lateral LA wall velocity, strain and strain rate were measured during ventricular systole from the apical 4-chamber view by velocity vector imaging. Results : There was greater percent of fibrosis as LA maximum (R = 0.4, p = 0.05) and minimum (R=0.52, p = 0.008) volumes increased. Figure shows examples of DE-CMRI and strain curves (C) for two patients: Patient 1(A) with mild fibrosis and patient 2 (B) with extensive fibrosis. Patient 1 shows much larger strain than patient 2. Larger LA volumes correlated inversely with maximal LA mid-lateral systolic wall strain (p < 0.005). The percent fibrosis also correlated inversely with maximal LA mid-lateral systolic wall strain (R=0.56, p < 0.005) and the systolic strain rate (R = 0.58, p = 0.002). Conclusion: LA strain and strain rate can be assessed using standard echocardiographic gray scale images. LA strain is related to both atrial volumes and fibrosis, which are markers of atrial disease progression. This relationship may represent changes in the properties of LA substrate. These novel imaging approaches may be helpful in predicting outcomes in patients with AF.

Association of Decreased Left Atrial Strain and Strain Rate with Stroke in Chronic Atrial Fibrillation

2011 ◽  
Vol 24 (5) ◽  
pp. 513-519 ◽  
Author(s):  
Jhih-Yuan Shih ◽  
Wei-Chuan Tsai ◽  
Yao-Yi Huang ◽  
Yen-Wen Liu ◽  
Chih-Chan Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Strain Rate ◽  
Left Atrial ◽  
Chronic Atrial Fibrillation ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

Abstract 2250: Is Atrial Fibrillation in Hypertrophic Cardiomyopathy Due to Left Atrial Structural Remodeling as Determined by Speckle-Derived Atrial Strain Imaging?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ying Shan ◽  
Grace Lin ◽  
Toshinori Yuasa ◽  
Fletcher A Miller ◽  
Steve R Ommen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
Strain Rate ◽  
Left Atrial ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Atrial Strain ◽  
Structural Remodeling ◽  
Strain And Strain Rate ◽  
Atrial Strain

Background: Atrial fibrillation (AF) is common in HCM yet the mechanisms are poorly understood but are likely secondary to either the consequences of left atrial structural remodeling (LASR) or myopathy, or triggers arising from pulmonary and other thoracic veins. The presence and severity of LASR as characterized by left atrial strain (LA ϵ), and its relationship to AF in HCM, has not been determined. Therefore, we measured LA ϵ and strain rate (SR) in Pts with HCM both with (AF+) and without (AF−) prior AF and compared these measures to those in age and gender matched controls without HCM or AF. Methods: Two-dimensional speckle-derived LA longitudinal peak ϵ, SR during systole (SR S ), early (SR E ) and late diastole (SR A ) were measured at the basal and mid portions of the lateral, septal, and posterior LA walls using Vector Velocity Imaging during sinus rhythm and were averaged. Results: Mean age of Pts in each of the matched groups was 56 ± 2 years (16 males; 59%). Significant left ventricular outflow tract obstruction was present in all Pts with HCM. Diastolic dysfunction was similar in both HCM groups and worse when compared to controls. Peak LA 3 , SR S , SR E , and SR A for each group is shown (table 1 ). HCM was associated with significantly lower LA ϵ and SR compared to controls. Although LA size was increased in Pts with HCM when compared to controls there was no correlation between LA size and ϵ or SR (p>0.05 for all). No differences in LA ϵ and SR were found between AF+ versus AF− Pts. Conclusion: HCM is associated with LASR as determined by decreased LA ϵ and SR. However, LA ϵ and SR were similar in AF+ versus AF− Pts suggesting that the occurrence of AF in HCM is not due to LASR alone. Table 1. Left Atrial Strain and Strain Rate in Hypertrophic Cardiomyopathy

P4372Left atrial strain: a potential marker of early diastolic dysfunction in patients with Marfan syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Garcia-Izquierdo Jaen ◽  
S Mingo Santos ◽  
M Torres Sanabria ◽  
V Monivas Palomero ◽  
S Moreno Casado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ejection Fraction ◽  
Strain Rate ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Healthy Controls ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

Abstract Background/Introduction Previous studies using conventional echocardiographic measurements have reported subclinical left diastolic dysfunction in patients with Marfan syndrome (MFS). Left atrial strain (LAS) has been shown to be an accurate predictor of left ventricular diastolic dysfunction. However, there is no evidence regarding the use of LAS in MFS. Purpose To assess feasibility of LAS and compare LAS derived measurements along with traditional diastolic parameters in MFS patients vs healthy controls. Methods 46 MFS patients (normal LV ejection fraction, no previous cardiovascular surgery, no significant valvular regurgitation) vs. 20 healthy controls (age and sex-matched). We performed LAS analysis using 2D speckle-tracking (QLAB 10, Philips). LA strain was determined as the average value of the longitudinal deformation (7 segments) in the apical 4-chamber view (RR gating). Results LAS analysis was feasible in 40 MFS patients (87%). All participants had normal diastolic function according to current guidelines (ASE/EACVI 2016). MFS patients showed lower TDI e' velocities and higher average E/e' ratio, but still within normal range. Similarly, LVEF was normal but slightly reduced in MFS patients. LA strain and strain rate parameters during reservoir and conduit phase were significantly impaired in MFS patients compared to controls. MFS vs controls MFS patients (n=40) Controls (n=20) p MFS patients (n=40) Controls (n=20) p Age 33.8±12.4 34.4±8.3 0.846 Septal e' (cm/s) 9.7±2.5 11.7±2.3 0.006 Male (%) 24 (60%) 12 (60%) 1.000 Average E/e' ratio 6.8±1.5 5.5±1.1 0.002 SBP (mmHg) 120.3±12.4 120.1±9.4 0.969 TR velocity (cm/s) 208.6±21.4 201.6±22.9 0.390 DBP (mmHg) 72.0±10.1 67.1±6.2 0.069 LAVi (ml/m2) 23.5±7.1 25.5±4.8 0.260 Aortic root (mm) 40.3±4.6 31.7±3.7 <0.001 LASr (%) 32.6±8.8 43.0±8.3 <0.001 LVEF (%) 60.9±5.6 64.2±4.2 0.022 LAScd (%) −20.1±8.0 −29.4±5.5 <0.001 E-wave (cm/s) 74.6±16.5 76.7±16.5 0.651 LASct (%) −12.8±6.1 −13.6±5.2 0.622 A-wave (cm/s) 55.2±10.9 52.0±12.8 0.327 LASRr 2.02±0.49 2.31±0.43 0.030 E/A ratio 1.4±0.4 1.5±0.4 0.287 LASRcd −2.22±0.61 −3.07±0.68 <0.001 Lateral e' (cm/s) 13.0±3.6 16.3±3.3 0.002 LASRct −2.24±0.90 −2.35±0.75 0.600 SBP: Systolic blood pressure. DBP: Diastolic blood pressure. LVEF: Left ventricular ejection fraction. LAVi: Left atrial volume index. LAS: Left atrial strain. LASR: Left atrial strain rate. (r): Reservoir. (cd): Conduit. (ct): Contraction. Example of LA strain and strain rate Conclusion MFS patients showed a subtle impairment in diastolic function compared to controls. Although further evidence is needed, LAS derived parameters could be early markers of diastolic dysfunction in this group of patients. Acknowledgement/Funding Programa de Actividades de I+D de la Comunidad de Madrid

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