Key result
Mitral stenosis was associated with a significant decline in left atrial peak systolic velocity, total velocity, strain, and strain rate compared to healthy subjects.
Why the study?
Does moderate to severe mitral valve disease (stenosis or regurgitation) impair left atrial reservoir function as measured by tissue Doppler, strain, and strain rate imaging compared to healthy subjects?
Observational (n=52)
Does moderate to severe mitral valve disease (stenosis or regurgitation) impair left atrial reservoir function as measured by tissue Doppler, strain, and strain rate imaging compared to healthy subjects?
Left atrial reservoir function, assessed by strain and strain rate imaging, is significantly more compromised in patients with moderate to severe mitral stenosis than in those with mitral regurgitation.
LA reservoir impairment appears greater in mitral stenosis than regurgitation; leaves open whether strain imaging aids risk stratification or intervention timing.
Introduction: Mitral valve stenosis and mitral valve regurgitation still result in significant morbidity and mortality. It has been shown that atrial remodeling and atrial fibrillation may occur in these patients. We sought to investigate how pressure or volume overload in the left atrium could impact atrial deformation properties obtained via Doppler-derived velocity and strain/strain rate imaging. Methods: Thirty-six patients, comprising 17 patients with a diagnosis of moderate to severe mitral stenosis and 19 patients with a diagnosis of moderate to severe mitral regurgitation, were compared with 16 healthy subjects. Two-dimensional, pulse Doppler, and tissue Doppler transthoracic echocardiographic study was performed. Measurement of regional velocity, strain and SR profiles, peak systolic velocity, peak strain, and strain rate was performed in two segments of the four left atrial walls. Results: There was a significant decline in peak systolic velocity in the mitral stenosis patients in both annular and roof segments, but the difference was not statistically significant between the mitral regurgitation patients and the healthy subjects. Total velocity was significantly lower in the mitral stenosis patients than in the healthy subjects, but the difference was not statistically significant between the healthy subjects and the mitral regurgitation patients. Comparison of total strain showed significant differences between the three groups mainly due to a decline in strain in the mitral stenosis patients in comparison with the other two groups. Comparison of total peak systolic strain rate between the groups showed significant differences due to a significant decline in the mitral stenosis group and a non-significant decline in the mitral regurgitation group by comparison with the healthy group. Conclusion: This reduction, especially in strain and strain rate, shows that the reservoir function of the left atrium could be compromised more severely in asymptomatic mitral stenosis patients.
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Ojaghi‐Haghighi et al. (2014) conducted an observational in Mitral valve disease (mitral stenosis and mitral regurgitation) (n=52). Moderate to severe mitral stenosis or mitral regurgitation vs. Healthy subjects was evaluated on Left atrial deformation properties (peak systolic velocity, total velocity, total strain, and strain rate). Mitral stenosis was associated with a significant decline in left atrial peak systolic velocity, total velocity, strain, and strain rate compared to healthy subjects.
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