Left atrial function by two-dimensional speckle tracking echocardiography in patients with severe rheumatic mitral stenosis and pulmonary hypertension

Abstract

We studied left atrial (LA) function in severe rheumatic mitral stenosis (MS) patients using two-dimensional speckle tracking echocardiography (STE). Eighty patients with isolated severe MS in sinus rhythm and 40 controls underwent comprehensive echocardiography including STE derived LA strain [reservoir strain (LAS_r), conduit strain (LAS_cd) and contractile strain (LAS_ct)]. The mean MVA was 0.93 ± 0.21 cm². The mean values of LAS_r (14.73 ± 8.59%), LAS_cd (-7.61 ± 4.47%) and LAS_ct (-7.16 ± 5.15%) in patients were significantly lower (p < 0.001) vs. controls 44.11 ± 10.44%, -32.45 ± 7.63%, -11.85 ± 6.77% respectively and showed decreasing trend with increasing MS severity and higher NYHA class. In conclusion, LA dysfunction is prevalent in severe MS irrespective of NYHA functional class.

Keywords: Left atrial dysfunction; Left atrial strain; Mitral stenosis; Speckle tracking echocardiography.