Left atrial myopathy in rheumatic mitral stenosis; three dimensional and speckle tracking echocardiography study
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Authors
Abdelgawad, Hoda
Dufatanye, Darius
Shehata, Mahmoud
Waheed, Ingy
Hesham, Noha
Rizk, Judy
Abayazeed, Rasha
Dawood, Moustafa
Abdel-Hay, Mohamed Ayman
Zaki, Amr
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Issue Date
2025
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Article
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Abstract
BACKGROUND: In developing countries, rheumatic mitral valve stenosis (MS) is still a problem and its progression leads to left atrial (LA) damage. Due to the complexity of the LA geometry, currently used techniques like antero-posterior dimension (LAD) and 2D echo derived LA volume (LAV) have several limitations that are corrected by 3D derived LA volumes in addition to functional evaluation. PURPOSE: To assess the LA functions using 2D speckle tracking echocardiography and 3D transthoracic echocardiography in patients with clinically significant MS in comparison to normal healthy subjects. RESULTS: Fifty patients and 50 healthy controls were studied. Patients' mean age was 40.2 ± 8.8 years, the majority were female 45(81.8%). 3D indexed LA maximum (LAVmaxI) and minimum (LAVminI) volumes were significantly higher in MS than in the control group, whereas 3D LA EF was significantly lower in MS than in the control group (p 0.001). LA strain reservoir, conduit, and contraction parameters were significantly lower in the MS group than in the control group ( CONCLUSIONS: Left atrial functional and structural remodelling has been highlighted in patients with significant rheumatic MS. However, left atrial functional assessment by 3D echocardiography and 2D speckle tracking echocardiography correlate better with mitral valve area than conventional LA size measurements. Whether the functional assessment of the LA has an additive predictive value with regards to patient outcome needs to be interrogated.
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Acta Cardiologica
Volume
80
Issue
3