Left atrial function, the cherrie on top in understanding clinical outcomes in functional mitral regurgitation

2020 ◽  
Vol 96 (3) ◽  
pp. 685-686
Author(s):  
Firas Zahr ◽  
Joaquin E. Cigaarroa
Keyword(s):  
Mitral Regurgitation ◽  
Clinical Outcomes ◽  
Left Atrial ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Functional Mitral Regurgitation

Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications

2019 ◽  
Vol 20 (9) ◽  
pp. 1012-1019 ◽  
Author(s):  
Giuseppe Palmiero ◽  
Enrico Melillo ◽  
Adele Ferro ◽  
Guido Carlomagno ◽  
Chiara Sordelli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Clinical Status ◽  
Right Ventricular Dysfunction ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Functional Mitral Regurgitation ◽  
Pathophysiological Role ◽  
Reduce Ejection Fraction

Abstract Aims Functional mitral regurgitation (FMR) is a well-known pathophysiological factor in heart failure (HF) patients, and left atrial function (LAF) is a novel determinant of clinical status and outcome in this setting. However, little is known about the pathophysiological role of FMR on LAF in HFrEF patients. Aim of this study is to explore the possible interplay between the severity of FMR and LAF in heart failure with reduce ejection fraction (HFrEF) patients and their possible consequences. Methods and results We studied 97 consecutive patients with FMR classified in two groups: mild-to-moderate MR ore less (FMR group, n = 38) and moderate-to-severe or more (SFMR group, n = 59). Using the phasic method, left atrial contractile, conduit, reservoir, and total emptying function (TLAEF) were calculated to assess LAF. SFMR group showed significantly lower values of LAF compared to FMR group. LA dysfunction (LA-dys) was defined for TLAEF values below the median and groups divided in four subgroups based on its presence. Patient with LA-Dys in SFMR group showed a worse clinical status, higher incidence of right ventricular dysfunction (RV-Dys), and pulmonary hypertension (PH), and a significant worse clinical survival compared to all other groups. Conclusion In our study, the survival was significantly lower in SFMR/LA-Dys+ group. Furthermore, LA-Dys was strongly related with worse clinical status and higher incidence of PH and RV-Dys. These results suggest that in patients with SFMR and HFrEF, LA-Dys may represent both a marker of more advanced disease and a novel prognostic factor.

scholarly journals Variation of Left Atrial Function in Different Stages of Mitral Regurgitation and Its Association With Guidelines-Based Surgical Indication

2020 ◽  
Vol 23 (6) ◽  
pp. E746-E751
Author(s):  
Fengming Bai ◽  
Lingfei Cun ◽  
Bo Li
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Atrial Volume ◽  
Current Guidelines

Purpose: The current guidelines associate indications for surgery in mitral regurgitation (MR) with left ventricle size and function. However, there is not enough emphasis in current guidelines on left atrial function, which is thought to be an important factor predicting adverse outcomes in MR. The aim of this study was to investigate the left atrial function at different stages of mitral regurgitation and its value in predicting the indications of mitral valve surgery. Methods: This was a retrospective study with 163 consecutive chronic primary MR patients who underwent color doppler echocardiography at the Guangxi Zhuang Autonomous Region Second People's Hospital between January 2016 and June 2018. All patients were in sinus rhythm, classified into three groups, according the degree of mitral regurgitation. Comparison was made with 30 control patients. Using Simpson’s methods, we recorded maximal left atrial volume, left atrial volume before active contraction and minimal left atrial volume, from which left atrial expansion index, left atrial passive emptying fraction, left atrial active emptying fraction, and the total left atrial emptying fraction were derived. Results: Left atrial volume was expanded and left atrial emptying fraction was reduced in the mitral regurgitation group. By multivariate analysis, left atrial passive emptying fraction and left atrial active emptying fraction were independent predictors of mitral regurgitation requiring surgery. Using receiver-operating characteristic analysis, left atrial passive emptying fraction <97.4% demonstrated 98% sensitivity and 67% specificity for predicting the presence of surgical indication (area under the curve: 0.91; P < .001). Conclusion: During mitral regurgitation, left atrial volume increases and functions decrease. The left atrial passive emptying fraction can be used as an additional tool to predict the indications of mitral valve surgery.

scholarly journals Left atrial eccentricity in chronic mitral regurgitation: relation to left atrial function

2012 ◽  
Vol 14 (2) ◽  
pp. 110-117 ◽  
Author(s):  
J.-E. Yi ◽  
W. B. Chung ◽  
J. S. Cho ◽  
C. S. Park ◽  
E. J. Cho ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrial ◽  
Atrial Function ◽  
Left Atrial Function

Changes in Left Atrial Function in Severe Valvular Mitral Regurgitation

2009 ◽  
Vol 18 ◽  
pp. S23
Author(s):  
E.M. Chia ◽  
J. Vidaic ◽  
D. Leung ◽  
L. Thomas
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrial ◽  
Atrial Function ◽  
Left Atrial Function

scholarly journals P2418Acute changes in left atrial function following interventional treatment for symptomatic mitral regurgitation

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
C. Ozturk ◽  
T. Fasell ◽  
J.M. Sinning ◽  
N. Werner ◽  
G. Nickenig ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrial ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Interventional Treatment
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