title: Effect of mitral valve replacement on reduction of left atrial size.
abstract: BACKGROUND
  asymptomatic left atrial enlargement is not uncommon in rheumatic mitral valve disease. We studied the change in size of the left atrium after mitral valve replacement.
  
  
  METHODS
  between January and December 2005, 116 patients underwent isolated mitral valve replacement. Two groups were identified based on left atrial size: group 1 < 60 mm (n = 79) and group 2 > 60 mm (n = 37). The patients were followed up for 40.4 ± 19.3 months Clinical assessment, preoperative and last postoperative echocardiograms were considered for analysis.
  
  
  RESULTS
  the left atrium decreased by 5.84 mm ± 10.5 in group 1 compared to 20.9 mm ± 10.64 in group 2 (p = 0.0001). This correlated with preoperative mitral valve area (p = 0.009), preoperative mitral regurgitation (p = 0.000), and preoperative atrial fibrillation (p = 0.022). Linear regression analysis revealed atrial fibrillation (p = 0.001, b1 = 6.006), a high grade of mitral regurgitation (p = 0.001, b1 = -3.812), and larger size of the left atrium (p = 0.000, b1 = -0.701) predicted a greater reduction of left atrial size during follow-up. Left atrial size decreased by 28 mm in patients with a preoperative left atrium >60 mm (75% sensitivity and 100% specificity).
  
  
  CONCLUSIONS
  the asymptomatic left atrium reduces in size considerably after mitral valve replacement, and the decrease is greater in patients with a left atrium >60 mm in size.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Pande
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Agarwal
authors.forename: Satyapriya
authors.initials: S
authors.lastname: Mohanty
authors.forename: Anubhav
authors.initials: A
authors.lastname: Bansal
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000209:etiology; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D015150:Echocardiography, Doppler; D006325:Heart Atria / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D016014:Linear Models; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Heart valve diseases; heart atria; heart valve prosthesis implantation; mitral valve; mitral valve insufficiency