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...
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MDPI AG
2023-07-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/8/320 |
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| author | Letizia Rosa Romano Giuseppe Scalzi Biagio Malizia Iolanda Aquila Alberto Polimeni Ciro Indolfi Antonio Curcio |
| author_facet | Letizia Rosa Romano Giuseppe Scalzi Biagio Malizia Iolanda Aquila Alberto Polimeni Ciro Indolfi Antonio Curcio |
| author_sort | Letizia Rosa Romano |
| collection | DOAJ |
| 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 (<i>n</i> = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (<i>n</i> = 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. |
| first_indexed | 2024-03-10T23:51:43Z |
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| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T23:51:43Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-af65e9e55f644de39c09c8e1d2ad93932023-11-19T01:37:53ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-07-0110832010.3390/jcdd10080320Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation ProgressionLetizia Rosa Romano0Giuseppe Scalzi1Biagio Malizia2Iolanda Aquila3Alberto Polimeni4Ciro Indolfi5Antonio Curcio6Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87100 Cosenza, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyDivision of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, ItalyTranscatheter 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 (<i>n</i> = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (<i>n</i> = 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.https://www.mdpi.com/2308-3425/10/8/320atrial fibrillationspeckle-tracking echocardiographyatrial cardiomyopathyTEERcath lab |
| spellingShingle | Letizia Rosa Romano Giuseppe Scalzi Biagio Malizia Iolanda Aquila Alberto Polimeni Ciro Indolfi Antonio Curcio Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression Journal of Cardiovascular Development and Disease atrial fibrillation speckle-tracking echocardiography atrial cardiomyopathy TEER cath lab |
| 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 | atrial fibrillation speckle-tracking echocardiography atrial cardiomyopathy TEER cath lab |
| url | https://www.mdpi.com/2308-3425/10/8/320 |
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