Purpose: We aimed to assess the relationship between mitral regurgitation (MR) severity, symptoms and left atrial (LA) structure and function, before and after mitral valve repair (MVR).
Methods: Global peak atrial longitudinal strain (PALS) was evaluated in 37 patients with severe symptomatic MR and preserved left ventricular (LV)EF (60.4±4.6%) before and 3 months after MVR and was compared with values from 30 age- and gender-matched controls.
Results: Before surgery, global PALS was reduced and indexed LA volume was increased (p<0.0001 for both). After MVR, both fell (p=0.001 and p=0.05, respectively) as did LVEF, longitudinal strain (LS) (p=0.05 and p<0.001, respectively) and LV mass (LVM) (p<0.0001).
Before surgery, LA volume correlated modestly with LV end-diastolic volume (R=0.51; p=0.01); EROA correlated with PALS (R=-0.69,p<0.001) and with LV LS (R=0.54,p=0.01); and NYHA class correlated with PALS (R=-0.69,p<0.001), EROA (R=0.69, p<0.001), and with LA volume (R=0.51, p=0.04). LA volume was the strongest predictor of global PALS reduction (p<0.001) while global PALS was the main predictor of post-operative atrial fibrillation (AF) (p<0.001),
Conclusions: In patients with severe MR, EROA correlate with symptoms and LA PALS which itself predicts the occurrence of post-operative AF. Strain values were superior to 2D-data for the prediction of post-operative AF.