Left atrial function and deformation in chronic primary mitral regurgitation.
OBJECTIVE
To study global and regional left atrial (LA) mechanics in chronic primary mitral regurgitation (MR) with echocardiography.


RESULTS
LA volumes during reservoir, conduit, and contractile phases were measured in 27 MR patients and 25 controls. LA ejection fraction (EF) and ejection force were calculated. Reservoir (SR-R), conduit (SR-C), and contractile phase (SR-A) strain rates, and reservoir phase strain were obtained. LA volumes were higher in MR in all phases. In MR, ejection force was increased (21.5 vs. 12.3 kdynes, P = 0.001); reservoir phase strain (32.91 +/- 14.26%), SR-R (2.65 +/- 0.87), SR-C (-2.02 +/- 0.58), and SR-A (-2.55 +/- 1.31 s(-1)) were increased (23.14 +/- 7.96%, 1.62 +/- 0.53, -1.29 +/- 0.59, -1.98 +/- 0.65 s(-1), in controls, respectively, P < or = 0.004). Regional deformation correlated with corresponding volumetric parameters. Despite enhanced SR-A in MR, LA EF was unchanged (31.34 vs. 29.23%, P = ns), and LA contractile tissue velocity (A') was reduced (-5.39 +/- 1.95 vs. -6.91 +/- 1.80 cm/s, P = 0.006). The LA contractile contribution to left ventricular filling was significantly reduced in MR.


CONCLUSIONS
LA deformation is increased in all phases in MR. Unchanged LA EF and reduced A' may reflect the reduced contractile contribution to left ventricular filling.
Borg
Alexander N
AN
Department of Cardiology, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. dr.alex.borg@googlemail.com
Pearce
Keith A
KA
Williams
Simon G
SG
Ray
Simon G
SG
D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology*; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology*