Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail Leaflets

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

“…347 For assessment of atrial size, most widely reported is the linear dimension in the parasternal long-axis view using M-mode or 2 delayed enhancement (DE). [324][325][326][327][328][329][330][331][332][333][334][335][336][337][338][339]345,[347][348][349] However, due to the complex 3D nature of the atrium and the non-uniform nature of atrial remodelling, this measurement frequently does not provide an accurate picture of LA size. 350 -354 Thus, when assessing LA size and remodelling, the measurement of LA volume is a more powerful prognostic indicator in a variety of cardiac disease states.…”

“…350 -354 Thus, when assessing LA size and remodelling, the measurement of LA volume is a more powerful prognostic indicator in a variety of cardiac disease states. 329,331,[333][334][335][336][337][338][339]345,[347][348][349][350][351][352][353][354][355][356][357][358][359][360] Two-dimensional echocardiographic LA volumes are typically smaller than those reported from computed tomography or cardiac magnetic resonance imaging (CMR). [361][362][363][364][365] Left atrium volume from 2D images is best measured using the disk summation algorithm because it includes fewer geometric assumptions.…”

Left Atrial Remodeling in Segmental vs. Global Mitral Valve Prolapse – Three-Dimensional Echocardiography –

“…A close relationship between LA remodeling and unfavorable outcomes has been established in MVP. 24, 25 The question of whether the clinical significance of generalized LA dilatation in segmental MVP, and that of inferiorly predominant LA dilatation in global MVP, differ, remains to be answered. The risks of atrial fibrillation due to LA dilatation in both segmental and global MVP, are extremely important.…”

Predictors of Long-Term Outcomes in Patients With Significant Myxomatous Mitral Regurgitation Undergoing Exercise Echocardiography

“…[6][7][8][9] In the absence of randomized, controlled trials, guidelines rely mainly on observational outcome studies. 10,11 Factors such as symptomatic deterioration, 3,12 severity of disease, 13 increased LV or LA dimensions, 14,15 and development of AF, 16,17 PHTN, 18 or LV dysfunction 3,19 have been associated with worse clinical outcomes. However, these studies vary in the definition of outcome 3,8,15,16,18 and have included limited numbers of patients, 8 only patients with flail leaflets, 14,15,18 patients with various disease origins, 12,19 Background-Significant myxomatous mitral regurgitation leads to progressive left ventricular (LV) decline, resulting in congestive heart failure and death.…”