Acute effect of treatment of mitral stenosis on left atrium function

Rohani, Atooshe; Kargar, Shahram; Fazlinejad, Afsoon; Ghaderi, Fereshte; Vakili, Vida; Falsoleiman, Homa; Bagheri, Ramin Khamene

doi:10.4103/0971-9784.197832

Cited by 15 publications

(11 citation statements)

References 9 publications

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“…Though many studies have been done studying the impact of balloon mitral valvotomy on atrial volumes, atrial pumping function, and atrial reservoir functions [9–11], not many studies have studied the effect of valvotomy of global left atrial strain. Rohani et al studied the acute effect of balloon mitral valvotomy and mitral valve replacement in patients with mitral stenosis and concluded that the peak atrial longitudinal strain (PALS) was impaired in patients with severe symptomatic mitral stenosis and improved acutely after treatment [12]. Hemodynamic changes following BMV include decrease in left atrium afterload which is reflected by an increase in mitral valve area, decrease in diastolic transmitral gradients, and decrease in systolic pulmonary artery pressure.…”

Section: Discussionmentioning

confidence: 99%

Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

et al. 2019

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BackgroundGlobal left atrial strain (LA) has been used as a novel assessment tool to evaluate left atrial function. However, not much has been investigated to study the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis on global LA strain. We studied the relationship between global left atrial (LA) strain and severe mitral stenosis and the effect of BMV on LA strain.ResultsA total of 29 patients satisfying the criteria for severe mitral stenosis underwent balloon mitral valvotomy (67% females; mean age, 39.53 ± 11.78 years). Global left atrial strain was assessed by speckle tracking echocardiography before and after valvuloplasty. Global LA strain was impaired in patients with severe mitral stenosis and improved 24–48 h following BMV (13.4 ± .75% vs 17.37 ± 6.95%, p < 0.001). There was a significant decrease in mitral mean gradient (MMG) (16.94 ± 6.62 mmHg vs 8.19 ± 4.01 mmHg, p < 0.001) and systolic pulmonary artery pressure (sPAP) (47.84 ± 9.07 mmHg vs 36.88 ± 7.69 mmHg, p < 0.001) after BMV. Mitral valve area (MVA) (1.045 ± 0.17 cm2 vs 1.94 ± 0.22 cm2, p < 0.001) significantly increased after BMV. Results were compared with 30 age- and sex-matched healthy controls.ConclusionGlobal LA strain can be taken as an indicator of left atrial function, and its improvement following valvotomy may be taken as a good indicator of successful BMV.

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Section: Discussionmentioning

confidence: 99%

Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

et al. 2019

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“…Rohani et al [14] found that the peak systolic global LA strain acutely improved post-balloon mitral valvuloplasty (p < 0.001) and after mitral valve replacement (p = 0.012). This difference was statistically highly significant.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Appendage Mechanical Changes in Patient with Mitral Stenosis Speckle Tracking Imaging Study

Kamel¹,

Emara²,

Shalaby³

et al. 2019

WJCD

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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 to severe 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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“…Atooshe Rohane et al., 2017 reported the effect of PTMC on 2D STE 1 . They recruited 46 patients undergoing either PTMC or surgical MVR irrespective of atrial rhythm abnormality—PALS significantly improved post‐intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Rheumatic MS accounts for approximately 40% of the valvulopathies in the world's developing regions. According to the annual report by the WHO in 2004, 1 about 12 million people are currently affected by rheumatic fever and heart disease worldwide, and high incidence rates are reported in the Indian subcontinent.…”

Section: Introductionmentioning

confidence: 99%

“…The more the decrease in mean MV gradient post-PTMC, the more compliant is left atrium, and less the acute increase in LA strain % as LA are already compliant. Similarly, in later stages of RHD with severe MS, the drop in MV mean gradient may be less post-successful PTMC, but the change in LA strain from a lower baseline value is more.Atooshe Rohane et al, 2017 reported the effect of PTMC on 2D STE 1. They recruited 46 patients undergoing either PTMC or surgical MVR irrespective of atrial rhythm abnormality-PALS significantly improved post-intervention.…”

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confidence: 99%

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Left atrial strain predicts improvement in left atrial functions of severe rheumatic mitral stenoses undergoing successful percutaneous transmitral commissurotomy

Sharma

Garg²,

Malani

2023

Echocardiography

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Aims Chronic rheumatic heart disease (RHD) is prevalent in India. The mitral valve in isolation or combination with the aortic or tricuspid valve is involved in 31.6% and 52.8% of chronic RHD patients, respectively. The left atrium (LA) functions as a reservoir during the cardiac cycle. Therefore, the LA enlargement leads to longitudinal lengthening, measured as a positive strain, permitting the measurement of the longitudinal strain of LA. This study aimed to assess the LA functions using peak atrial longitudinal strain (PALS) in patients with severe rheumatic mitral stenoses (MS) in sinus rhythm who underwent successful percutaneous transvenous mitral commissurotomy (PTMC). Material and Methods We recruited 56 patients with severe rheumatic MS for the study, of which 06 PTMC procedures were considered unsuccessful. So, 50 patients of chronic severe rheumatic MS in sinus rhythm undergoing PTMC were enrolled in a tertiary care centre of the Armed Forces from August 2017 to May 2019. Patients included in the study were not consecutive, and patients with atrial fibrillation (AF) were excluded. Results PALS improved post‑PTMC (P < .001) in this study, effectively concluding that PALS is impaired in patients with severe symptomatic MS and is acutely enhanced after treatment. Conclusions PALS is a good indicator of LA function and may predict the success of PTMC on the rheumatic mitral valve.

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Acute effect of treatment of mitral stenosis on left atrium function

Cited by 15 publications

References 9 publications

Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

Left Atrial Appendage Mechanical Changes in Patient with Mitral Stenosis Speckle Tracking Imaging Study

Left atrial strain predicts improvement in left atrial functions of severe rheumatic mitral stenoses undergoing successful percutaneous transmitral commissurotomy

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