In primary mitral regurgitation, left atrial reservoir and conduit functions are significantly more impaired in mitral valve prolapse patients, with conduit function predicting atrial fibrillation (P=
Does mitral valve prolapse worsen left atrial dysfunction compared to non-prolapse in patients with primary mitral regurgitation?
In patients with primary mitral regurgitation, mitral valve prolapse is associated with more severe left atrial dysfunction beyond volume overload, with impaired conduit function serving as a potential risk marker for atrial fibrillation.
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Abstract Background Mitral regurgitation (MR) has a significant hemodynamic impact on the left atrium (LA). However, the impact of mitral valve prolapse (MVP) on LA dysfunction remains unknown. Cardiovascular magnetic resonance feature tracking (CMR-FT) is an accurate method for the quantitative assessment of LA dysfunction. Purpose This study sought to evaluate the LA dysfunction in primary MR patients with and without MVP using CMR-FT. Methods A total of 119 primary MR patients (68 MVP and 51 non-MVP) were enrolled. CMR-FT quantified LA reservoir (εs, SRs), conduit (εe, SRe), and pump function (εa, SRa). Multivariate regression analysis identified predictors of atrial fibrillation (AF). Results Compared with non-MVP patients, the LA reservoir (εs, SRs) and conduit (εe, SRe) functions were significantly impaired in MVP patients (all p0.05). Besides, in the MVP subgroups, εa and SRe was significantly impaired in patients with late gadolinium enhancement. In multivariate analysis, only SRe independently predicted AF (P=0.014). Conclusion In primary MR patients, LA dysfunction is more prevalent in MVP than non-MVP, suggesting a unique pathophysiology beyond volume overload in MVP. LA conduit function may represent a risk marker of AF.
Song et al. (Sat,) reported a other. In primary mitral regurgitation, left atrial reservoir and conduit functions are significantly more impaired in mitral valve prolapse patients, with conduit function predicting atrial fibrillation (P=.