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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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 |
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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 |
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