Assessment of the left atrial volume and function following percutaneous mitral balloon valvuloplasty: Insights into acute and late impact of atrial fibrillation on atrial remodeling

• Published in: International journal of cardiology 2024-01, Vol.394, p.131361, Article 131361
• Main Authors: Soares, Juliana Rodrigues, Carvalho, Vinicius Tostes, Lodi-Junqueira, Lucas, Fonseca, Isabella Moreira Gonzalez, Athayde, Guilherme Rafael Sant'Anna, de Sales, Igor Ferreira, Caldas, Ana Clara de Paula, Carvalho, Pedro Emanuel de Paula, Matos, Tobias Kennedy Gonçalves, Mello, Luana Aguiar, Esteves, William Antonio M., Tan, Timothy C., Levine, Robert A., Hung, Judy, Nunes, Maria Carmo Pereira
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; Left atrial remodeling; Mitral stenosis; Percutaneous mitral balloon valvuloplasty; Three-dimensional echocardiography
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2023.131361

Rheumatic mitral stenosis (MS) leads to LA remodeling with disordered electrical activation that may revert with valve intervention. This study aimed to assess the acute and late impact of percutaneous mitral balloon valvuloplasty (PMBV) on LA volume and function in patients with atrial fibrillation (AF) compared with sinus rhythm. A total of 167 patients with severe MS undergoing PMBV were prospectively enrolled. LA volumes and function were measured by three-dimensional echocardiography (3DE) pre PMBV, within 24 to 48 h after PMBV, and at 1 year. Mean age was 43.5 ± 11.8 years old, and 142 (85%) patients were women. At baseline, 46 patients (27.5%) were in permanent AF, and 62 (37.1%) classified as New York Heart Association functional class III or IV. In sinus rhythm population, LA volumes decreased immediately after PMBV and continue to decrease at 1-year follow-up. LA emptying fraction increased from 23.6 ± 10.4% to 33.8 ± 11.9% acutely after the procedure (p