Impact of Left Atrial Volume on Clinical Outcome in Organic Mitral Regurgitation

Abstract

In organic MR, LA index at diagnosis predicts long-term outcome, incrementally to known predictors of outcome. This marker of risk is particularly important because mitral surgery in these patients markedly improves outcome and restores life expectancy. LA index should be measured in routine clinical practice for risk-stratification and for clinical decision making in patients with organic MR.

Assessment of Left Atrial Deformation and Function by 2‐Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease

“…Specifically, LA remodeling includes adaptive and maladaptive processes, such as alterations in the composition of extracellular matrix with excessive fibroblast proliferation, and myocyte hypertrophy, necrosis, and apoptosis 45, 46. All of these ultrastructural changes significantly affect LA myocardial wall properties, such as relaxation and compliance, ultimately leading to the observed reduction of LA phasic functions assessed by STE 40, 47, 48. An interesting finding of the present study was the observed lower PALS in dogs with MMVD class B1 compared with that of healthy dogs, whereas LA areas and almost all STE‐derived variables were not different between these groups of dogs.…”

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

“…[311][312][313][314][315][316] In the absence of MVD, an increase in LA size most commonly reflects increased wall tension as a result of increased LA pressure, [317][318][319][320] as well as impairment in LA function secondary to atrial myopathy. 321,322 A clear relationship exists between an enlarged LA and the incidence of atrial fibrillation and stroke, [323][324][325][326][327][328][329][330][331][332] risk for overall mortality after myocardial infarction, 321,322,333,334 risk for death and hospitalization in patients with dilated cardiomyopathy, [335][336][337][338][339][340][341][342][343][344] and major cardiac events or death in patients with diabetes mellitus.…”

Quantitative assessment of the left atrial myocardial deformation in patients with chronic mitral regurgitation by strain and strain rate imaging: an observational study

“…LA remodeling caused by MR is target organ damage (3). LA remodeling causes chronic inflammatory changes, myocyte hypertrophy, interstitial fibrosis, impaired elastic properties with elevated pressure, and dimensional enlargements (4,5). LA enlargement is an important risk factor for atrial fibrillation, undesired cardiovascular events, stroke, and sudden cardiac death (1,2,6,7).…”