Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

Abstract

LA/LAA dysfunction is a serious concern in patients with severe mitral stenosis, which may lead to blood stasis and thromboembolic consequences, as well as heart failure.In this research, we aimed to examine the impact of PBMV on LA/LAA function, specifically focusing on mitral annulus Sa velocity, SEC grade and LAA TDI parameters, in order to identify the determinants of improved LA/LAA function. Methods: Preliminary research was undertaken between June 2020 and April 2022 at a Tertiary Care Hospital in the United States. At the National Heart Institute's Cardiology Department, a total of 50 patients with symptomatic, isolated, severe mitral stenosis underwent PBMV surgery. Dyspnea was a common symptom in more than half of our patients, most of whom were in their 30s and 40s (NYHA class II). An improved LA/LAA SEC grade, decreased mitral valve diastolic pressure gradient and decreased diastolic left atrial diameter were all seen following PBMV. After PBMV, mitral annular Sa velocity, LAAEV, and LAAFV were all significantly improved. " We also found that improvement in LA/LAA function after PBMV was significantly predicted by mitral annular Sa velocity. The SEC grade of the LA/LAA was shown to be a major predictor of improvement in LA/LAA function following PBMV. Our findings showed that the mital annular Sa velocity cutoff value was 5.5 cm/s was the ideal speed for predicting an inactive LAA. The cutoff value for LAAEV in our investigation was 25 cm/sec for the prediction of inactive LA/LAA. Conclusion: Pre-PBMV inactivity was predicted by lower Sa-wave velocity; after PBMV inactivity was predicted by higher Sa-wave velocity, higher LAAEV, lower SEC grade, lower left atrial diameter, larger MVA and lower PASP. Specifically, lower left atrial diameter, larger MVA and lower PASP were associated with improved LA function after PBMV.