Prediction of left atrial fibrosis with speckle tracking echocardiography in mitral valve disease: a comparative study with histopathology.
OBJECTIVE
Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. However, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle tracking echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery.


METHODS
Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).


RESULTS
Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was independent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confidence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=-0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant.


CONCLUSIONS
Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease.
Division of Cardiology, Kangwon National University Hospital, Chuncheon, Korea.
Ae-Young
AY
Her
Eui-Young
EY
Choi
Chi Young
CY
Shim
Byoung Wook
BW
Song
Sak
S
Lee
Jong-Won
JW
Ha
Se-Joong
SJ
Rim
Ki Chul
KC
Hwang
Byung Chul
BC
Chang
Namsik
N
Chung