Uğur AKSU

Comparison of the effects of mitral regurgitation and pulmonary arterial hypertension on left atrial functions

Aim: The left atrium (LA) is a cardiac chamber that plays a fundamental role in successful cardiac pumping function and the mortalityis more frequent in patients withLA dysfunction. Both of left cardiac pathologies such as mitral regurgitation (MR) and right cardiacpathologies such as pulmonary hypertension (PHT) may cause structural and functional alteration in LA. In the present study, weexamined the effects of PHT and MR on LA functions by making use of deformation parameters.Material and Methods: 58 patients followed up with diagnoses of MR (32) and PHT (28) and healthy subjects (28) having thedemographical characteristics similar to those of patients were involved in the present study. The deteriorations of LAfunctions ofpatients, changes of affected parameters among the disease groups, and the clinical effects of these changes were examined.Results: 88 patients were involved in the present study. The mean age was 38.7±4.5 years, and 34% of the participants were male.AlthoughLA functions were found to be deteriorated in both diseases when compared to the control group in univariate analysis, thedifference was found only in deformation analyses (p:0.02). In MR group, LA functions were determined to be lower than both of PHTand control group. In correlation analysis, both of the diseases were found to be significantly related with LAS and LASR.Conclusions: In the present study, we showed that both of the diseases may affect the LA functions at various levels and, whencompared to conventional methods,LAS and LASR parameters can provide more accurate information about the severity of bothdiseases.

PDF

___

1. Argulian E, Seetharam K. Echocardiographic 3D-guided 2D planimetry in quantifying left-sided valvular heart disease. Echocardiography 2018;35:695-706.
2. Vieira MJ, Teixeira R, Goncalves L, et al. Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr 2014;27:463-78.
3. Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-63.
4. Tuleta I, Eckstein N, Aurich F, et al. Reduced longitudinal cardiac strain in asthma patients. J Asthma 2018:1-10. 5. Kasprzak JD, Huttin O, Wierzbowska-Drabik K, Imaging the Right Heart-Pulmonary Circulation Unit: The Role of Ultrasound. Heart Fail Clin 2018;14:361-76.
6. McMurray JJ, Adamopoulos S, Anker SD, et al. [ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012]. Turk Kardiyol Dern Ars 2012;40:77-137.
7. Spencer KT, Kimura BJ, Korcarz CE, et al. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2013;26:567-81.
8. Ramu B, Elwan AM, Coleman CI, et al. The Association Between Baseline Left Atrial Volume Index and All-Cause Mortality in Patients with Heart Failure: A Meta-Analysis. Conn Med 2015;79:469-75.
9. Aksu U, Aksu D, Gulcu O, et al. The effect of dialysis type on left atrial functions in patients with end-stage renal failure: A propensity score-matched analysis. Echocardiography 2018;35:308-13.
10. Aksu U, Gulcu O, Aksakal E, et al. Comparison of the three conventional methods for the postoperative atrial fibrillation prediction. Echocardiography 2017;34:831-34.
11. Calleja AM, Rakowski H, Williams LK, et al. Left atrial and ventricular systolic and diastolic myocardial mechanics in patients with end-stage renal disease. Echocardiography 2016;33:1495-503.
12. Kim SJ, Oh HJ, Yoo DE, et al. Left atrial enlargement is associated with a rapid decline in residual renal function in ESRD patients on peritoneal dialysis. J Am Soc Echocardiogr 2012;25:421-7.
13. Aruta P, Muraru D, Guta AC, et al. Comparison of mitral annulus geometry between patients with ischemic and non-ischemic functional mitral regurgitation: implications for transcatheter mitral valve implantation. Cardiovasc Ultrasound 2018;16:27.
14. Quien MM, Vainrib AF, Freedberg RS, et al. Advanced Imaging Techniques for Mitral Regurgitation. Prog Cardiovasc Dis 2018;61:390-6.
15. Cameli M, Incampo E, Mondillo S. Left atrial deformation: Useful index for early detection of cardiac damage in chronic mitral regurgitation. Int J Cardiol Heart Vasc 2017;17:17-22.
16. ang LT, Shih JY, Liu YW, et al. Effects of left atrial strain on functional capacity in chronic severe mitral regurgitation. Int J Cardiol 2013;168:e151-3.