Structural and Functional Left Atrial Remodelling in Rheumatic Mitral
Stenosis; Combined Three-Dimensional and Speckle Tracking
Echocardiography Study
Abstract
Aims LA functions assessment using 2D speckle tracking
echocardiography and 3D transthoracic echocardiography in
moderate-severe mitral valve stenosis in comparison to normal subjects.
Methods and results Fifty patients and 50 controls were
studied. Patients’ mean age was 40.2 ±8.8 years, the majority were
female 45(81.8%), the mean body surface area was 1.81 ± 0.16 m2. 3D LA
maximum (LAVmaxI) and minimum (LAVminI) volumes indexed to BSA were both
significantly higher in MS than in control group, whereas 3D LA EF was
significantly lower in MS than in control group, both with p 0.001.LA
strain reservoir, conduit, and contraction parameters were significantly
lower in the MS group than in control group (p =0.001). All LA
assessment parameters (3D LAVmaxI, 3D LAVminI, 3D LAEF, 2D LASr, 2D
LAScd, 2D LASct, 2D LAD, 2D LAVI) correlated with each other (p
<0.01). However, only 3D LAEF, 2D LASr, 2D LAScd, and 2D LASct
showed correlation with the mitral valve area with p <0.05,
but 3D LAVmaxI and 3D LAVminI did not. Additionally, in comparison of
moderate and severe MS subgroups, 3D LAVmaxI and 3D LAVminI did not show
any statistically significant differences between the two groups,
although 3D LAEF, 2D LASr, 2D LAScd, and 3D LASct showed significant
difference between the two group( p<0.05).
Conclusions Comprehensive LA assessment is of clinical
significance for its predictive and prognostic value in mitral stenosis.
In addition, LA function assessment by 3D echocardiography and 2D
speckle tracking echocardiography correlate better with MS severity than
conventional LA size parameters.