Time course of left atrial reverse remodelling after mitral valve surgery and the impact of left ventricular global longitudinal strain in patients with chronic severe mitral regurgitation

Peter Chipeta, Chi Young Shim, Geu Ru Hong, Darae Kim, In Jeong Cho, Sak Lee, Hyuck Jae Chang, Byung Chul Chang, Jong Won Ha, Namsik Chung

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES: We aimed to investigate the time course of left atrial (LA) reverse remodelling (LARR) after mitral valve (MV) surgery in patients with chronic severe mitral regurgitation (MR) and examine the impact of left ventricular (LV) mechanical function on LARR. METHODS: A total of 140 patients (73 males, age 54 ± 16 years) with chronic severe MR undergoing MV surgery were analysed. All patients underwent two-dimensional, Doppler and speckle-Tracking echocardiography before and after surgery (1 week, 6 months and 12 months). RESULTS: There was a significant decrease in LA volume from 137.8 ± 85.5 to 89.7 ± 54.6 ml (-32.1 ± 16.7%, P < 0.001) at 1 week after surgery. LA volume further decreased to 77.4 ± 52.4 ml (-9.9 ± 13.4%, P < 0.001) at 6 months but increased to 79.7 ± 62.4 ml (3.6 ± 11.9%, P = 0.002) at 12 months after surgery. Patients with good LARR (a reduction of ≥25% in LA volume) showed lower LV global longitudinal strain (LV-GLS) than those with poor LARR (P = 0.032). In simple correlation, age (r = 0.19, P = 0.026), preoperative LA volume (r = -0.28, P = 0.001) and preoperative LV-GLS (r = 0.28, P = 0.001) showed significant correlations with the % change in LA volume, whereas no correlations were observed with preoperative LV ejection fraction, global circumferential and radial strain. In multivariate analyses, preoperative LV-GLS (β = 0.24, P = 0.014) was an independent determinant for early LARR along with age and preoperative LA volume. CONCLUSIONS: The majority of LARR after MV surgery occurred during the early postoperative period. LV-GLS, age and LA volume at surgery determined the degree of early LARR after MV surgery in patients with chronic severe MR.

Original languageEnglish
Pages (from-to)876-882
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume23
Issue number6
DOIs
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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