Left atrial strain and distensibility in relation to left ventricular dysfunction and prognosis in aortic stenosis

• Published in: Echocardiography (Mount Kisco, N.Y.) N.Y.), 2019-03, Vol.36 (3), p.469-477
• Main Authors: Meimoun, Patrick, Djebali, Manel, Botoro, Thierry, Djou MD, Urbain, Bidounga, Honorine, Elmkies, Frederic, Martis, Sonia, Clerc, Jérome
• Format: Article
• Language: English
• Subjects: Aged; aortic stenosis; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - physiopathology; death; distensibility; Echocardiography; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; heart failure; Humans; left atrium; Male; Prognosis; Prospective Studies; Severity of Illness Index; strain; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.14258

Objective To test the relationship between left atrial (LA) distensibility (LAD), LA strain (LAS), and left ventricular (LV) dysfunction and prognosis in aortic stenosis (AS). Methods Transthoracic Doppler echocardiography was performed prospectively in 102 consecutive patients with AS (77 with severe, 25 with moderate, mean age 77 years). LA volume was calculated by the area‐length method in apical four‐ and two‐chamber views, immediately before mitral valve opening (Volmax) and at mitral valve closure (Volmin). LAD was defined as (Volmax – Volmin) × 100%/Volmin. LAS (mean of maximal strain from the 4–2 chamber views) was conducted using a dedicated software package. The endpoint was hospitalization for heart failure and death from any cause. Results Left atrial strain, LAD, and LA vol/m² were significantly correlated with LV diastolic parameters, and PASP (all, P