Department of Cardiology, CHU de Caen, Caen, France.
Medical School, Université Caen Normandie, UNICAEN, CHU Caen, Caen, France.
Echocardiography. 2021 Jan;38(1):47-56. doi: 10.1111/echo.14925. Epub 2020 Nov 11.
We examined the left atrial stiffness index (LA Stiff) on echocardiography and its determinants in adults and adolescents with repaired congenital left ventricular outflow obstructions (c-LVOOs), including isolated subaortic stenosis (SAS), stenotic bicuspid aortic valve (BAV), and aortic coarctation (CoA).
Seventy-two patients (43 males, age: 31 ± 15 years) with repaired c-LVOOs (SAS: n = 12; BAV: n = 27; CoA: n = 33) were compared to 72 age- and sex-matched controls. 2D strain imaging was performed to assess left ventricular (LV) and LA function, including peak positive longitudinal LA strain (LAS), late diastolic LA strain (LDS), and LV global longitudinal strain (GLS). The (E/Ea)/LAS ratio was used to calculate LA Stiff.
LA Stiff was significantly higher in the c-LVOO group than in the control group. Among the c-LVOO patients, the CoA group had the lowest GLS and the highest LA Stiff; no significant differences were found with respect to sex, hypertension history, smoking status, or repeated repair among c-LVOO subtypes. Multivariable regression analysis with the variables "BMI" and "c-LVOO subtype" revealed that BMI and c-LVOO subtypes were independently associated with LA Stiff (b = 0.290, P = .009 and b = 0.353, P = .002, respectively).
We documented abnormal LA Stiff values in adults and adolescents after c-LVOO repair. Patients with CoA demonstrated the most impaired LA Stiff values. Overweight may contribute to worse LA Stiff values. Further studies are required to determine the prognostic implications of LA Stiff in patients with repaired c-LVOOs.
我们研究了超声心动图左心房僵硬度指数（LA Stiff）及其在修复先天性左心室流出道梗阻（c-LVOO）成人和青少年中的决定因素，包括单纯主动脉瓣下狭窄（SAS）、二叶式主动脉瓣狭窄（BAV）和主动脉缩窄（CoA）。
72 例（男 43 例，年龄：31 ± 15 岁）修复后的 c-LVOO 患者（SAS：n = 12；BAV：n = 27；CoA：n = 33）与 72 例年龄和性别匹配的对照组进行比较。使用二维应变成像评估左心室（LV）和左心房功能，包括峰值正向纵向 LA 应变（LAS）、舒张晚期 LA 应变（LDS）和 LV 整体纵向应变（GLS）。（E/Ea）/LAS 比值用于计算 LA Stiff。
c-LVOO 组的 LA Stiff 明显高于对照组。在 c-LVOO 患者中，CoA 组的 GLS 最低，LA Stiff 最高；c-LVOO 各亚型之间，性别、高血压史、吸烟史或重复修复均无显著差异。多变量回归分析显示，“BMI”和“c-LVOO 亚型”与 LA Stiff 独立相关（b = 0.290，P =.009 和 b = 0.353，P =.002）。
我们记录了 c-LVOO 修复后成人和青少年异常的 LA Stiff 值。CoA 患者的 LA Stiff 值受损最严重。超重可能导致 LA Stiff 值恶化。需要进一步研究以确定修复后的 c-LVOO 患者 LA Stiff 的预后意义。
