Cargando…

Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression

Transcatheter edge-to-edge repair (TEER) currently represents a valuable therapeutic option for patients with severe mitral regurgitation (MR) considered at high surgical risk. Besides symptoms and left ventricular (LV) echocardiographic improvements upon TEER, it has been postulated that left atria...

Descripción completa

Detalles Bibliográficos
Autores principales: Romano, Letizia Rosa, Scalzi, Giuseppe, Malizia, Biagio, Aquila, Iolanda, Polimeni, Alberto, Indolfi, Ciro, Curcio, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456079/
https://www.ncbi.nlm.nih.gov/pubmed/37623333
http://dx.doi.org/10.3390/jcdd10080320
_version_ 1785096609865924608
author Romano, Letizia Rosa
Scalzi, Giuseppe
Malizia, Biagio
Aquila, Iolanda
Polimeni, Alberto
Indolfi, Ciro
Curcio, Antonio
author_facet Romano, Letizia Rosa
Scalzi, Giuseppe
Malizia, Biagio
Aquila, Iolanda
Polimeni, Alberto
Indolfi, Ciro
Curcio, Antonio
author_sort Romano, Letizia Rosa
collection PubMed
description Transcatheter edge-to-edge repair (TEER) currently represents a valuable therapeutic option for patients with severe mitral regurgitation (MR) considered at high surgical risk. Besides symptoms and left ventricular (LV) echocardiographic improvements upon TEER, it has been postulated that left atrial (LA) function plays a prognostic role. The aims of our study were to evaluate LA changes after TEER, measured by two-dimensional speckle-tracking echocardiography analysis (2D-STE), their association with atrial fibrillation (AF) occurrence, and relative arrhythmic burden. We considered in a single-center study 109 patients affected by symptomatic severe MR undergoing TEER from February 2015 to April 2022. By 2D-STE, LA reservoir (R_s), conduct (D_s), and contractile (C_s) strains were assessed along with four-chamber emptying fraction (LAEF-4CH) before, 1, 6, and 12 months following TEER. Statistical analysis for comparison among baseline, and follow-ups after TEER was carried out by ANOVA, MANOVA, and linear regression. Successful TEER significantly improved LV dimensions and LA performances, as indicated by all strain components, and LAEF-4CH after 1 year. Strikingly, a significant reduction in arrhythmic burden was observed, since only one case of subclinical AF detected by a previously implanted cardiac electronic device was found in the cohort of sinus rhythm patients (n = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (n = 61) compared to baseline, together with few episodes of nonsustained ventricular tachycardias (5/61, 8.2%) after MR improvement. Overall, TEER was associated with improved cardiac performance, LA function amelioration, and reduced arrhythmic burden.
format Online
Article
Text
id pubmed-10456079
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104560792023-08-26 Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression Romano, Letizia Rosa Scalzi, Giuseppe Malizia, Biagio Aquila, Iolanda Polimeni, Alberto Indolfi, Ciro Curcio, Antonio J Cardiovasc Dev Dis Article Transcatheter edge-to-edge repair (TEER) currently represents a valuable therapeutic option for patients with severe mitral regurgitation (MR) considered at high surgical risk. Besides symptoms and left ventricular (LV) echocardiographic improvements upon TEER, it has been postulated that left atrial (LA) function plays a prognostic role. The aims of our study were to evaluate LA changes after TEER, measured by two-dimensional speckle-tracking echocardiography analysis (2D-STE), their association with atrial fibrillation (AF) occurrence, and relative arrhythmic burden. We considered in a single-center study 109 patients affected by symptomatic severe MR undergoing TEER from February 2015 to April 2022. By 2D-STE, LA reservoir (R_s), conduct (D_s), and contractile (C_s) strains were assessed along with four-chamber emptying fraction (LAEF-4CH) before, 1, 6, and 12 months following TEER. Statistical analysis for comparison among baseline, and follow-ups after TEER was carried out by ANOVA, MANOVA, and linear regression. Successful TEER significantly improved LV dimensions and LA performances, as indicated by all strain components, and LAEF-4CH after 1 year. Strikingly, a significant reduction in arrhythmic burden was observed, since only one case of subclinical AF detected by a previously implanted cardiac electronic device was found in the cohort of sinus rhythm patients (n = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (n = 61) compared to baseline, together with few episodes of nonsustained ventricular tachycardias (5/61, 8.2%) after MR improvement. Overall, TEER was associated with improved cardiac performance, LA function amelioration, and reduced arrhythmic burden. MDPI 2023-07-28 /pmc/articles/PMC10456079/ /pubmed/37623333 http://dx.doi.org/10.3390/jcdd10080320 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Romano, Letizia Rosa
Scalzi, Giuseppe
Malizia, Biagio
Aquila, Iolanda
Polimeni, Alberto
Indolfi, Ciro
Curcio, Antonio
Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title_full Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title_fullStr Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title_full_unstemmed Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title_short Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression
title_sort impact of percutaneous mitral valve repair on left atrial strain and atrial fibrillation progression
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456079/
https://www.ncbi.nlm.nih.gov/pubmed/37623333
http://dx.doi.org/10.3390/jcdd10080320
work_keys_str_mv AT romanoletiziarosa impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT scalzigiuseppe impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT maliziabiagio impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT aquilaiolanda impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT polimenialberto impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT indolficiro impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression
AT curcioantonio impactofpercutaneousmitralvalverepaironleftatrialstrainandatrialfibrillationprogression