Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

Abstract Background Global left atrial strain (LA) has been used as a novel assessment tool to evaluate left atrial function. However, not much has been investigated to study the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis on global LA strain. We studied the relationship between global left atrial (LA) strain and severe mitral stenosis and the effect of BMV on LA strain. Results A total of 29 patients satisfying the criteria for severe mitral stenosis underwent balloon mitral valvotomy (67% females; mean age, 39.53 ± 11.78 years). Global left atrial strain was assessed by speckle tracking echocardiography before and after valvuloplasty. Global LA strain was impaired in patients with severe mitral stenosis and improved 24–48 h following BMV (13.4 ± .75% vs 17.37 ± 6.95%, p < 0.001). There was a significant decrease in mitral mean gradient (MMG) (16.94 ± 6.62 mmHg vs 8.19 ± 4.01 mmHg, p < 0.001) and systolic pulmonary artery pressure (sPAP) (47.84 ± 9.07 mmHg vs 36.88 ± 7.69 mmHg, p < 0.001) after BMV. Mitral valve area (MVA) (1.045 ± 0.17 cm2 vs 1.94 ± 0.22 cm2, p < 0.001) significantly increased after BMV. Results were compared with 30 age- and sex-matched healthy controls. Conclusion Global LA strain can be taken as an indicator of left atrial function, and its improvement following valvotomy may be taken as a good indicator of successful BMV.

Download Full-text

Faculty Opinions recommendation of Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.2881958.2550057 ◽

2010 ◽

Author(s):

Vincent Sorrell ◽

Nishant Kalra

Keyword(s):

Left Atrial ◽

Speckle Tracking ◽

Atrial Function ◽

Left Atrial Function ◽

Two Dimensional ◽

Left Atrial Strain ◽

Atrial Strain

Download Full-text

Echocardiographic Measurement of Left Atrial Strain as a Tool for Assessing Left Atrial Function and Geometric Change

Korean Circulation Journal ◽

10.4070/kcj.2012.42.5.302 ◽

2012 ◽

Vol 42 (5) ◽

pp. 302 ◽

Cited By ~ 2

Author(s):

Kye Hun Kim

Keyword(s):

Left Atrial ◽

Atrial Function ◽

Left Atrial Function ◽

Left Atrial Strain ◽

Echocardiographic Measurement ◽

Atrial Strain

Download Full-text

Changes in diastology and atrial function in multimodality imaging after breast cancer radiotherapy - a six-year follow-up study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.127 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

M Vaarpu ◽

L Lehmonen ◽

S Kivisto ◽

T Skytta ◽

P-L Kellokumpu-Lehtinen ◽

...

Keyword(s):

Breast Cancer ◽

Left Atrial ◽

Multimodality Imaging ◽

Atrial Function ◽

Left Atrial Function ◽

Left Atrial Strain ◽

Cancer Radiotherapy ◽

Breast Cancer Radiotherapy ◽

Atrial Strain

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): State research funding (Finland) Heart Hospital funding (Tampere, Finland) Aims Breast cancer radiotherapy (RT) increases the incidence of heart failure with preserved ejection fraction with long latency. The prevalence and the early phases of this process are not well characterized. The aims of our study were to evaluate changes in diastology and left atrial function after breast cancer RT in a prospective manner. Methods 31 patients with early stage left-sided breast cancer were studied prior to RT, immediately after RT and three and six years after RT. Biomarkers were measured and echocardiography, including left atrial strain, was performed at each visit. Cardiac magnetic resonance imaging (CMR) was performed at the six-year follow-up (FU). Results At baseline, the median diastology gradus was 1 with 5 patients displaying diastology gradus greater than 2. At six-year follow-up the median diastology gradus had increased to 2 (p = 0.012) with 13 patients in diastology gradus 3-4. Additionally, proBNP increased progressively from baseline level of 63 [37, 124] ng/l to post-RT level of 84 [40, 154] ng/l (p = 0.031), to 90 [46, 132] ng/l at the three-year follow-up (p = 0.021) and to 98 [50, 176] ng/l at the six-year follow-up (p = 0.010). Left atrial strain initially increased from 23.2 ± 4.9% at baseline to 25.5 ± 6.7% post-RT (p = 0.199) and thereafter decreased to 21.2 ± 6.0% (p = 0.002) at six-year follow-up. There was no correlation in left atrial strain between 2D-echocardiography and CMR. Age (mean 62.2 years) had no correlation with changes in diastology or left atrial strain. Furthermore, left atrial strain rate (SR) increased progressively from 2.14 [1.83, 2.50]1/s at baseline to 2.35 [1.95, 2.96]1/s at the three-year follow-up (p = 0.040) and thereafter declined to 1.92 [1.62, 2.59]1/s (p = 0.014). The change in left atrial SR (from RT to the six-year control) was independently correlated with body mass index (BMI) (p = 0.044, β=0.472). The changes in diastology had no independent predictors. Conclusions RT induced a gradual worsening in diastology gradus, which was initially compensated with an increase in left atrial function. However, at the six-year follow-up, 43.7% of the patients had restrictive or pseudonormal diastology and a significant decline in left atrial strain and SR were detected. A lower BMI had a negative influence on the left atrial function. Abstract Figure. Changes in diastoly during six-year FU

Download Full-text