Key result
Moderate to severe mitral stenosis was associated with significantly reduced left atrial appendage mechanical function, including lower strain and strain rates, compared to healthy volunteers.
Why the study?
Active left atrial appendage blood flow and contractile function may be disturbed in mitral stenosis, and 2D speckle tracking echocardiography enables quantification of its mechanical function.
Does 2D speckle tracking echocardiography detect reduced left atrial appendage mechanical function in patients with mitral stenosis and sinus rhythm compared to healthy controls?
Case-Control (n=55)
Does 2D speckle tracking echocardiography detect reduced left atrial appendage mechanical function in patients with mitral stenosis and sinus rhythm compared to healthy controls?
2D speckle tracking echocardiography demonstrates that left atrial appendage mechanical function is significantly impaired in patients with mitral stenosis even when in sinus rhythm.
Speckle tracking may aid LAA assessment in mitral stenosis with sinus rhythm; hypothesis-generating for thromboembolic risk.
Background: LAA is the major site of thrombus formation in mitral stenosis; active LAA blood flow and contractile function may be disturbed in MS. TEE is the modality of choice for evaluating LAA and Speckle-tracking echocardiography (STE) is a recently developed technique for the characterization and quantification of myocardial deformation. It permits measurement of LA and LAA strain and strain rate which can be used to assess the mechanical function of LAA. Objective: To assess the mechanical function of left atrial appendage (LAA) in mitral stenosis (MS) patients with sinus rhythm by 2D speckle tracking strain and strain rate through transesophageal echocardiography (TEE). Patients & Method: Thirty-three patients with moderate tosevere MS and sinus rhythm, 38.33 ± 5.66 years as a case group and twenty-two age and sex matched healthy volunteers as a control group. All participants underwent compete conventional transthoracic echocardiography; TEE for assessment of LAA morphology and Doppler flow and speckle tracking strain & strain rate were measured from LAA walls. Results: LAA Doppler flow peak velocities, LAA strain, reservoir strain rate (RSr), conduit strain rate (CSr) and atrial contractile strain rate (ASr) all were significantly lower in patient group. Global Strain of LAA had a negative correlation with LA diameter, pulmonary artery systolic pressure & degree of spontaneous echo contrast and a positive correlation with MS area and LAA Doppler flow.Conclusion: 2D speckle tracking strain and strain rate of LAA is a feasible technique and is significantly reduced in patients with mitral stenosis even with sinus rhythm.
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Kamel et al. (2019) conducted a case-control in Mitral stenosis (n=55). Moderate to severe mitral stenosis vs. Healthy volunteers was evaluated on Left atrial appendage mechanical function (Doppler flow peak velocities, strain, and strain rates). Moderate to severe mitral stenosis was associated with significantly reduced left atrial appendage mechanical function, including lower strain and strain rates, compared to healthy volunteers.
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