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.

Left Atrial Roof: An Alternative Minimal Approach for Mitral Valve Surgery

2012 ◽  
Vol 7 (6) ◽  
pp. 417-420 ◽  
Author(s):  
Giampiero Esposito ◽  
Giangiuseppe Cappabianca ◽  
Samuele Bichi ◽  
Davide Patrini ◽  
Pasquale Pellegrino
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Mitral Repair ◽  
Venous Cannula ◽  
Surgical Incisions ◽  
Effective Option

Objective The most common surgical incisions to expose the mitral valve include a paraseptal left atriotomy or a transeptal biatrial approach. Both techniques are normally performed through a full sternotomy and bicaval cannulation. We report our experience with an alternative incision to expose the mitral valve using the left atrial roof (LAR) through a complete sternotomy or a J-shaped upper ministernotomy. Methods Between 2007 and 2011, a total of 512 patients underwent mitral procedures using the LAR approach. A J-shaped ministernotomy was performed in 189 patients, and 61 of these had concomitant aortic valve/root procedures. A standard sternotomy was performed in 323 patients, and 126 of these had concomitant aortic valve/root procedures. The repair rate in patients with mitral regurgitation was 398 of 460 (86.5%). Results In-hospital mortality was 2.3%. An adjunctive pericardial patch to repair the LAR was necessary in 1.9% of patients. A permanent pacemaker was necessary in 3.1% of patients. Four-year survival rate was 91% ± 4.2%. In patients who underwent mitral repair, 4-year freedom from mitral regurgitation greater than 2 was 97.4%. Conclusions The LAR approach is a safe and effective option to perform mitral valve surgery. The limited extension of this incision and the possibility to use a single venous cannula make this approach suitable for minimally invasive isolated mitral valve procedures, whereas the proximity of the LAR to the aortic root makes this approach particularly attractive for combined mitroaortic procedures through a ministernotomy.

Atrial function after left atrial epicardial cryoablation for atrial fibrillation in patients undergoing mitral valve surgery

2011 ◽  
Vol 33 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Birgitta Johansson ◽  
Odd Bech-Hanssen ◽  
Eva Berglin ◽  
Per Blomström ◽  
Anders Holmgren ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Atrial Function

A Preliminary Study of Left Atrial Function and Left Atrial Stiffness in Type 2 Diabetic Patients with Normotensive Patients Without Symptomatic Cardiovascular Disease

2021 ◽  
Author(s):  
Liping Huang ◽  
Xiangming Zhu ◽  
Guobing Hu ◽  
Xia Zhang ◽  
Guojie Li ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Volume ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Volume Index ◽  
Diabetic Patients ◽  
Atrial Volume ◽  
Type 2 Diabetic Patients ◽  
Left Atrial Volume Index

Abstract Background: The purpose of this study was to investigate the relationship between left atrial function and left atrial stiffness in type 2 diabetic patients.Methods: A total of 41 healthy subjects (controls) and 39 patients with type 2 diabetes mellitus (DM2 patients) were enrolled in this study. The left atrial volume index was measured by biplanar Simpson method. The early and late diastolic velocities (e'and a') were measured by tissue Doppler in lateral and septal boeder of the mitral annulus. Lateral and septal myocardial velocities were averaged. E/eʹ ratio was computed.The peak atrial longitudinal strain (PALS) was analyzed by tow-dimensional speckle tracking imaging (2D-STI) technique.The ratio of E/e ' to PALS was used as an indicator of LASI.Results:The maximum volume (LAVImax), minimum volume (LAVImin) and pre-contraction volume (LAVIpre) of the left atrium in DM2 patients were significantly higher than those in the control groups, and the differences were statistically significant (P<0.05). The difference between PALS decrease and LASI increase was statistically significant (P<0.05).PALS and LASI were statistically correlated with three phase volume index of left atrial and E/e'ratio. LASI was superior to PALS and left atrial volume index in diagnosing diabetic normotensive patients without symptomatic cardiovascular disease.Conclusion: Compared with the controls, PALS decreased and LASI increased in DM2. PALS and LASI were significantly correlated with left atrial volume and E/e’. LASI showed the highest diagnostic efficacy in the diagnosis of diabetes. PALS and LASI can be used as indicators for early evaluation of left atrial function in patients with DM2.Trial registration number:+86-17856931224;date of registration:May 3,2021

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