Change search
ReferencesLink to record
Permanent link

Direct link
Left atrial remodelling in patients undergoing transcatheter aortic valve implantation: a speckle-tracking prospective, longitudinal study.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Show others and affiliations
2013 (English)In: The international journal of cardiovascular imaging, ISSN 1569-5794, Vol. 29, no 8, 1717-1724 p.Article in journal (Refereed) Published
Abstract [en]

Aortic stenosis (AS) results in several left ventricular (LV) disturbances as well as progressive left atrial (LA) enlargement and dysfunction. Transcatheter aortic valve implantation (TAVI) reverses LV remodelling and improves overall systolic function but its effect on LA function remains undetermined. The aim of this prospective, longitudinal study was to investigate the effects of TAVI on LA structure and function. We studied thirty-two patients with severe symptomatic AS who underwent TAVI, using standard and 2-dimensional speckle-tracking echocardiography before, at 40-day and at 3-month follow-up. Following TAVI, mean transvalvular gradient decreased (p < 0.001). Both LA area index and LA volume index decreased at 40-day follow-up (16.2 ± 6.4 vs. 12.5 ± 2.9 cm(2)/m(2), and 47.3 ± 12.0 vs. 42.8 ± 12.5 mL/m(2), respectively, p < 0.05) and values remained unchanged at 3 months. The reduction of LA size was accompanied by a significant increase in global peak atrial longitudinal strain (14.4 ± 3.9 vs. 19.1 ± 4.7 %, p < 0.001) and in global peak atrial contraction strain (8.4 ± 2.5 vs. 11.0 ± 4.1 %, p < 0.05) at 3-month follow-up. LA stiffness measurements significantly decreased 3 months after TAVI (0.93 ± 0.59 vs. 0.65 ± 0.37, respectively, p < 0.001). Trans-aortic mean gradient change and pre-procedural LA volume were identified as predictors of global peak atrial longitudinal strain increase (β = -0.41, β = -0.35, respectively, p < 0.0001) while pre-procedural LA volume and trans-aortic mean gradient change as predictor of LA volume index reduction 3 months after TAVI (β = -0.37, β = -0.28, respectively, p < 0.0001). TAVI is associated with significant recovery of LA structure and function suggesting a reverse cavity remodelling. Such functional recovery is primarily determined by the severity of pre-procedural valve stenosis.

Place, publisher, year, edition, pages
Springer Netherlands, 2013. Vol. 29, no 8, 1717-1724 p.
Keyword [en]
Strain, Atrial function, Transcatheter aortic valve replacement, Echocardiography, Diastolic function, LA mechanics
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:umu:diva-79930DOI: 10.1007/s10554-013-0265-zPubMedID: 23852277OAI: diva2:645307
Available from: 2013-09-04 Created: 2013-09-04 Last updated: 2014-01-14Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Henein, Michael
By organisation
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 35 hits
ReferencesLink to record
Permanent link

Direct link