THE ROLE OF LEFT ATRIAL COMPLIANCE IN THE DEVELOPMENT OF PULMONARY HYPERTENSION IN PATIENTS WITH PURE MITRAL STENOSIS AND SINUS RHYTHM

Abstract Background Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence. Methods This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses. Results Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72). Conclusions LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

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Left Atrial Function by Two-Dimensional Speckle Tracking Echocardiography in Patients with Severe Rheumatic Mitral Stenosis and Pulmonary Hypertension

Indian Heart Journal ◽

10.1016/j.ihj.2021.12.011 ◽

2021 ◽

Author(s):

Vimal Mehta ◽

Dhanjibhai Chaudhari ◽

Pratishtha Mehra ◽

Sudhanshu Mahajan ◽

Jamal Yusuf ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Mitral Stenosis ◽

Left Atrial ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Atrial Function ◽

Left Atrial Function ◽

Two Dimensional ◽

Rheumatic Mitral Stenosis

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Clinical and Echocardiographic Profile of Rheumatic Heart Disease: A Cross-Sectional Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i27b31496 ◽

2021 ◽

pp. 1-7

Author(s):

Abdul Qadir Khan Dall ◽

Muhammed Kashif Shaikh ◽

Syed Zulfiquar Ali Shah ◽

Tarachand Devrajani ◽

Abdul Salam Memon ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Mitral Stenosis ◽

Left Atrial ◽

Left Atrial Enlargement ◽

Atrial Enlargement ◽

The Common ◽

Echocardiographic Findings ◽

Rheumatic Heart

Background: Rheumatic Heart disease (RHD) is the leading cause of acquired heart disease and more prevalent in developing countries. The objective of the study was to determine the clinical and echocardiographic profiles of patients with rheumatic heart disease (RHD). Materials and Methods: All patients above the age of 12 years of either gender diagnosed with Rheumatic heart disease from January 2018 to December 2019 at tertiary care hospital, Hyderabad were enrolled in the study. Detailed patient data was obtained from the hospital records. Information regarding gender, age, Electrocardiogram findings, clinical and echocardiographic manifestations was obtained. Results: Throughout the two-year study period, a total of fifty patients with RHD were studied. The mean age of the population was 33.71 years. Females (64%) outnumbered males and 60% were rural population. The clinical features observed were fever (80%), joint pain (64%), palpitation (60%), breathlessness (90%) and chest pain (50%), tachycardia (60%), raised JVP (10%), hypertension (20%). The common echocardiographic findings observed were mitral stenosis (50%), mitral regurgitation (24%) and pulmonary hypertension (36%), left atrial enlargement (56%), and right atrial enlargement (16%) whereas the majority of the patients (70%) have ejection fraction between 40-50% and thrombus was identified in 15 (30%) patients respectively. Conclusion: Common clinical findings observed were breathlessness and fever while the common echocardiographic findings were mitral stenosis and regurgitation, pulmonary hypertension, and left atrial enlargement. Population-based screening by echocardiography could be a potential route for early screening of rheumatic heart disease.

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