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Prediction of left atrial fibrosis with speckle tracking echocardiography in mitral valve disease: a comparative study with histopathology.

Her AY, Choi EY, Shim CY, Song BW, Lee S, Ha JW, Rim SJ, Hwang KC, Chang BC, Chung N - Korean Circ J (2012)

Bottom Line: Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery.LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured.LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Kangwon National University Hospital, Chuncheon, Korea.

ABSTRACT

Background and objectives: Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. However, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle tracking echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery.

Subjects and methods: Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).

Results: Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was independent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confidence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=-0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant.

Conclusion: Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease.

No MeSH data available.


Related in: MedlinePlus

Correlation between LA global strain and degree of LA fibrosis (A) and its subgroup analysis according to predominant mitral valve disease (B). Correlation of percent LA volume reduction after surgery with degree of LA fibrosis (C) and LA global strain (D). LA: left atrial, MS: mitral stenosis, MR: mitral regurgitation.
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Figure 2: Correlation between LA global strain and degree of LA fibrosis (A) and its subgroup analysis according to predominant mitral valve disease (B). Correlation of percent LA volume reduction after surgery with degree of LA fibrosis (C) and LA global strain (D). LA: left atrial, MS: mitral stenosis, MR: mitral regurgitation.

Mentions: The mean degree of LA fibrosis was 29.3±18.7%, with higher degrees in the MS group than in the MR group (36.5±20.4% vs. 20.1±11.0%, p=0.001). Table 3 shows correlates of LA fibrosis. AF, MS rather than MR, rheumatic heart disease, LA reservoir fraction (r=-0.314, p=0.027), LA global strain (r=-0.546, p<0.001), and LA systolic global strain rate (r=-0.276, p<0.001) were significantly correlated with degree of LA fibrosis. But, LAVImax did not correlate with degree of fibrosis. Among 12 LA segments, mid-septal strain correlated best with the degree of fibrosis (r=-0.510, p<0.001). However, preoperative LAVImax and the LV global strain did not correlate with the degree of LA fibrosis. In multivariate analysis, the degree of LA fibrosis was significantly correlated with the LA global strain even after adjustment for age, underlying rhythm, rheumatic heart disease, and predominant disease. In subgroup analysis according to predominant disease, LA global strain was better correlated with degree of LA fibrosis in patients with predominant MS than in subjects as a whole (r=-0.639, p<0.001) (Fig. 2). However, LAVImax did not correlate with the degree of fibrosis. In MR-predominant patients, LA global strain was not significantly correlated with degree of fibrosis (r=-0.370, p=0.099). In subgroup AF and sinus rhythm subgroups, LA global strain correlated with degree of fibrosis but degree of correlation was not significantly different due to small sample size (Table 4).


Prediction of left atrial fibrosis with speckle tracking echocardiography in mitral valve disease: a comparative study with histopathology.

Her AY, Choi EY, Shim CY, Song BW, Lee S, Ha JW, Rim SJ, Hwang KC, Chang BC, Chung N - Korean Circ J (2012)

Correlation between LA global strain and degree of LA fibrosis (A) and its subgroup analysis according to predominant mitral valve disease (B). Correlation of percent LA volume reduction after surgery with degree of LA fibrosis (C) and LA global strain (D). LA: left atrial, MS: mitral stenosis, MR: mitral regurgitation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369962&req=5

Figure 2: Correlation between LA global strain and degree of LA fibrosis (A) and its subgroup analysis according to predominant mitral valve disease (B). Correlation of percent LA volume reduction after surgery with degree of LA fibrosis (C) and LA global strain (D). LA: left atrial, MS: mitral stenosis, MR: mitral regurgitation.
Mentions: The mean degree of LA fibrosis was 29.3±18.7%, with higher degrees in the MS group than in the MR group (36.5±20.4% vs. 20.1±11.0%, p=0.001). Table 3 shows correlates of LA fibrosis. AF, MS rather than MR, rheumatic heart disease, LA reservoir fraction (r=-0.314, p=0.027), LA global strain (r=-0.546, p<0.001), and LA systolic global strain rate (r=-0.276, p<0.001) were significantly correlated with degree of LA fibrosis. But, LAVImax did not correlate with degree of fibrosis. Among 12 LA segments, mid-septal strain correlated best with the degree of fibrosis (r=-0.510, p<0.001). However, preoperative LAVImax and the LV global strain did not correlate with the degree of LA fibrosis. In multivariate analysis, the degree of LA fibrosis was significantly correlated with the LA global strain even after adjustment for age, underlying rhythm, rheumatic heart disease, and predominant disease. In subgroup analysis according to predominant disease, LA global strain was better correlated with degree of LA fibrosis in patients with predominant MS than in subjects as a whole (r=-0.639, p<0.001) (Fig. 2). However, LAVImax did not correlate with the degree of fibrosis. In MR-predominant patients, LA global strain was not significantly correlated with degree of fibrosis (r=-0.370, p=0.099). In subgroup AF and sinus rhythm subgroups, LA global strain correlated with degree of fibrosis but degree of correlation was not significantly different due to small sample size (Table 4).

Bottom Line: Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery.LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured.LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Kangwon National University Hospital, Chuncheon, Korea.

ABSTRACT

Background and objectives: Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. However, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle tracking echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery.

Subjects and methods: Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).

Results: Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was independent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confidence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=-0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant.

Conclusion: Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease.

No MeSH data available.


Related in: MedlinePlus