Division of Cardiology, Kangwon National University Hospital, Chuncheon, Korea.
Korean Circ J. 2012 May;42(5):311-8. doi: 10.4070/kcj.2012.42.5.311. Epub 2012 May 24.
Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. However, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle tracking echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery.
Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39).
Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was independent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confidence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=-0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant.
Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease.
左心房（LA）纤维化是 LA 重构和房颤发展的主要决定因素。然而，LA 纤维化的无创预测具有挑战性。我们研究了斑点追踪超声心动图测量的术前 LA 应变是否可以预测二尖瓣（MV）手术后 LA 纤维化的程度和 LA 逆重构。
50 例患者在 MV 手术前一天进行斑点追踪超声心动图和 LA 容量测量。在手术期间获取 LA 组织，并测量其间质纤维化程度。在手术后 30 天内（n=50）和 1 年后（n=39）重复 LA 容量测量。
LA 整体应变与 LA 纤维化程度呈显著负相关（r=-0.55，p<0.001），其相关性独立于年龄、基础节律、风湿性心脏病的存在以及主要 MV 疾病的类型（B=-1.37，95%置信区间 -2.32 - -0.41，p=0.006）。LA 纤维化程度与 MV 手术后早期（r=-0.337，p=0.017）和 1 年（r=-0.477，p=0.002）LA 容量减少百分比显著相关，但 LA 整体应变无显著相关性。
斑点追踪超声心动图测量的 LA 应变可能有助于预测 MV 疾病患者的 LA 纤维化程度。
