Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression

被引:9
作者
Romano, Letizia Rosa [1 ]
Scalzi, Giuseppe [1 ]
Malizia, Biagio [1 ]
Aquila, Iolanda [1 ]
Polimeni, Alberto [2 ]
Indolfi, Ciro [1 ]
Curcio, Antonio [1 ]
机构
[1] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Div Cardiol, I-88100 Catanzaro, Italy
[2] Univ Calabria, Dept Pharm Hlth & Nutr Sci, Div Cardiol, I-87100 Cosenza, Italy
关键词
atrial fibrillation; speckle-tracking echocardiography; atrial cardiomyopathy; TEER; cath lab; AMERICAN SOCIETY; REGURGITATION; INTERVENTIONS;
D O I
10.3390/jcdd10080320
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Transcatheter edge-to-edge repair (TEER) currently represents a valuable therapeutic option for patients with severe mitral regurgitation (MR) considered at high surgical risk. Besides symptoms and left ventricular (LV) echocardiographic improvements upon TEER, it has been postulated that left atrial (LA) function plays a prognostic role. The aims of our study were to evaluate LA changes after TEER, measured by two-dimensional speckle-tracking echocardiography analysis (2D-STE), their association with atrial fibrillation (AF) occurrence, and relative arrhythmic burden. We considered in a single-center study 109 patients affected by symptomatic severe MR undergoing TEER from February 2015 to April 2022. By 2D-STE, LA reservoir (R_s), conduct (D_s), and contractile (C_s) strains were assessed along with four-chamber emptying fraction (LAEF-4CH) before, 1, 6, and 12 months following TEER. Statistical analysis for comparison among baseline, and follow-ups after TEER was carried out by ANOVA, MANOVA, and linear regression. Successful TEER significantly improved LV dimensions and LA performances, as indicated by all strain components, and LAEF-4CH after 1 year. Strikingly, a significant reduction in arrhythmic burden was observed, since only one case of subclinical AF detected by a previously implanted cardiac electronic device was found in the cohort of sinus rhythm patients (n = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (n = 61) compared to baseline, together with few episodes of nonsustained ventricular tachycardias (5/61, 8.2%) after MR improvement. Overall, TEER was associated with improved cardiac performance, LA function amelioration, and reduced arrhythmic burden.
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页数:12
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