title: Left atrial asynchrony and mechanical function in patients with mitral stenosis before and immediately after percutaneous balloon mitral valvuloplasty: a real time three-dimensional echocardiography study.
abstract: OBJECTIVE
  This study evaluated the feasibility of assessing left atrium (LA) function and asynchrony in patients with rheumatic mitral stenosis (MS) before and immediately after percutaneous balloon mitral valvuloplasty (PBMV) by real time three-dimensional echocardiography (RT3DE).
  
  
  METHODS
  Thirty patients with rheumatic MS who underwent PBMV and 30 controls were enrolled. RT3DE was used to measure LA volume and function, the standard deviation of time to the minimal systolic volume divided into 16 segments, 12 segments, or 6 segments (Tmsv 16-SD, Tmsv 12-SD, Tmsv 6-SD), and the maximum differences (Tmsv 16-Dif, 12-Dif, 6-Dif) in RT3DE derived values in MS patients before and 2 days after PBMV were obtained and compared with those of normal controls. The associations between the LA asynchrony and heart volume, function, mitral valve area (MVA), maximum mitral valve gradient (MVGmax ), mean mitral valve gradient (MVGmean), and mean LA pressure (MLAP) were investigated.
  
  
  RESULTS
  Left atrium asynchrony indexes were significantly larger, and LA function parameters were significantly lower in the MS group than in the controls (P < 0.05 for all). Of all the LA asynchrony indexes, LA Tmsv16-SD was most significantly correlated with the LA volume and function parameters, MVGmax , MVGmean , and MLAP (P < 0.05 for all). LA asynchrony indexes and LA volume significantly deceased, and LA function significantly increased post-PBMV (P < 0.05).
  
  
  CONCLUSIONS
  Real time three-dimensional echocardiography is a reliable and reproducible method to quantify LA function and asynchrony. RT3DE revealed a significant, early improvement in LA function and asynchrony in MS patients after PBMV.
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Deng
authors.forename: Sheng-lan
authors.initials: SL
authors.lastname: Guo
authors.forename: Hong-yue
authors.initials: HY
authors.lastname: Su
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Tan
authors.forename: Ji
authors.initials: J
authors.lastname: Wu
authors.forename: Di
authors.initials: D
authors.lastname: Zhang
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: asynchrony; atrial fibrillation; left atrium; real time three-dimensional echocardiography; rheumatic mitral stenosis