Volume 46, Issue 1 pp. 32-40

Research Article

Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair

Matteo Lisi MD,

Corresponding Author

Matteo Lisi MD

[email protected]

orcid.org/0000-0003-4591-2030

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

Correspondence Matteo Lisi, Department of Cardiovascular Disease, University of Siena, Policlinico Le Scotte, Viale Bracci n° 1, 53100 Siena, Italy. Email: [email protected]Search for more papers by this author

Matteo Cameli MD,

Matteo Cameli MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Cristina Di Tommaso MD,

Cristina Di Tommaso MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Valeria Curci MD,

Valeria Curci MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Rosanna Reccia MD,

Rosanna Reccia MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Flavio D'ascenzi MD,

Flavio D'ascenzi MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Marta Focardi PhD,

Marta Focardi PhD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Massimo Maccherini MD,

Massimo Maccherini MD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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Mario Chiavarelli MD,

Mario Chiavarelli MD

Department of Cardiac Surgery, University of Siena, Siena, Italy

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Gianfranco Lisi MD,

Gianfranco Lisi MD

Department of Cardiac Surgery, University of Siena, Siena, Italy

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Per Lindqvist PhD,

Per Lindqvist PhD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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Sergio Mondillo MD,

Sergio Mondillo MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Michael Henein MD, PhD,

Michael Henein MD, PhD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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Matteo Lisi MD,

Corresponding Author

Matteo Lisi MD

[email protected]

orcid.org/0000-0003-4591-2030

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

Matteo Cameli MD,

Matteo Cameli MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Cristina Di Tommaso MD,

Cristina Di Tommaso MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Valeria Curci MD,

Valeria Curci MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Rosanna Reccia MD,

Rosanna Reccia MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Flavio D'ascenzi MD,

Flavio D'ascenzi MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Marta Focardi PhD,

Marta Focardi PhD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

Search for more papers by this author

Massimo Maccherini MD,

Massimo Maccherini MD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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Mario Chiavarelli MD,

Mario Chiavarelli MD

Department of Cardiac Surgery, University of Siena, Siena, Italy

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Gianfranco Lisi MD,

Gianfranco Lisi MD

Department of Cardiac Surgery, University of Siena, Siena, Italy

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Per Lindqvist PhD,

Per Lindqvist PhD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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Sergio Mondillo MD,

Sergio Mondillo MD

Department of Cardiovascular Disease, University of Siena, Siena, Italy

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Michael Henein MD, PhD,

Michael Henein MD, PhD

Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden

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First published: 26 September 2017

https://doi.org/10.1002/jcu.22521

Citations: 9

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Abstract

Purpose

We aimed to assess the relationship between mitral regurgitation (MR) severity, symptoms, and left atrial (LA) structure and function, before and after mitral valve repair (MVR).

Methods

Global peak atrial longitudinal strain (PALS) was evaluated in 37 patients with severe symptomatic MR and preserved left ventricular (LV) ejection fraction (60.4% ± 4.6%) before and 3 months after MVR and was compared with values from 30 age- and gender-matched controls.

Results

Before surgery, PALS was worse in patients than in controls and indexed LA volume was greater (P < .0001 for both). After MVR, PALS deteriorated further and LA volume decreased (P = .001 and P = .05, respectively) as did LV ejection fraction, longitudinal strain (P = .05 and P < .001, respectively), and LV mass (P < .0001). Before surgery, LA volume correlated modestly with LV end-diastolic volume (R = 0.51; P = .01); effective regurgitant orifice area (EROA) correlated with PALS (R = −0.69, P < .001) and with LV longitudinal strain (R = 0.54, P = .01), and New York Heart Association class correlated with PALS (R = −0.69, P < .001), EROA (R = 0.69, P < .001), and LA volume (R = 0.51, P = .04). LA volume was the strongest predictor of global PALS reduction (P < .001), whereas global PALS was the main predictor of postoperative atrial fibrillation (AF) (P < .001).

Conclusions

In patients with severe MR, EROA correlate with symptoms and LA PALS, which itself predicts the occurrence of postoperative AF. Strain values were superior to 2D data for the prediction of postoperative AF.

CONFLICT OF INTEREST

The authors declare that they have no conflicts of interest with the contents of this article.

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Volume46, Issue1

January 2018

Pages 32-40

Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair

Abstract

Purpose

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair

Abstract

Purpose

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

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