Linder Timor, Sudarsky Doron, Grosman-Rimon Liza, Rimon Jordan, Shuvy Mony, Carasso Shemy
Cardiovascular Institute, Tzafon Medical Center, Poriya 1528001, Israel.
The Azriely Faculty of Medicine, Bar-Ilan University, Zefat 1311502, Israel.
J Clin Med. 2024 Nov 29;13(23):7282. doi: 10.3390/jcm13237282.
Conventional echocardiography used to assess volumes of the left ventricle (LV) and left atrium (LA) along with mitral regurgitation grade is routine in studies before and after transcatheter edge-to-edge mitral valve repair (Mitral TEER). Previous studies focus on LV parameter changes and comparison of the functions before and a few months following Mitral TEER implantation, as well as LA reverse remodeling, by assessing LV volumes. However, less is known regarding LA strain changes in the early phase after the procedure. The objective of the study was to assess the effect of Mitral TEER on LA strain early after TEER procedure. The retrospective study included 44 patients who underwent Mitral TEER. LA strain and volumes were evaluated by speckle tracking echocardiography at the baseline and 24-48 h following the procedure. Demographic, echocardiographic, and clinical characteristics were obtained and statistically analyzed. LA global longitudinal strain (GLS) reservoir improved significantly (from 12.2 ± 7 to 14.7 ± 6.4, = 0.0079) after Mitral TEER. Significant improvements were also seen in LA volumes (LA maximal and minimal volume), which reduced by 17% and 22.5% respectively. LV GLS was significantly changed (from -9.8% to -12.8%, < 0.0001) following Mitral TEER, whereas LV stroke volume was not significantly different between the baseline and post-Mitral TEER ( = 0.7798). After successful Mitral TEER, there was a very early improvement in LA function. Two-dimensional speckle tracking echocardiography may contribute to our understanding of LA functional changes immediately post-procedure.
在经导管二尖瓣缘对缘修复术(Mitral TEER)前后的研究中,常规超声心动图用于评估左心室(LV)和左心房(LA)的容积以及二尖瓣反流分级。以往的研究主要关注Mitral TEER植入术前和术后几个月左心室参数的变化、功能比较以及通过评估左心室容积观察左心房逆向重构。然而,对于术后早期左心房应变的变化了解较少。本研究的目的是评估Mitral TEER术后早期对左心房应变的影响。这项回顾性研究纳入了44例行Mitral TEER的患者。在基线期和术后24 - 48小时通过斑点追踪超声心动图评估左心房应变和容积。获取人口统计学、超声心动图和临床特征并进行统计学分析。Mitral TEER术后左心房整体纵向应变(GLS)储备显著改善(从12.2±7提高到14.7±6.4,P = 0.0079)。左心房容积(左心房最大和最小容积)也有显著改善,分别减少了17%和22.5%。Mitral TEER术后左心室GLS显著改变(从-9.8%变为-12.8%,P<0.0001),而左心室每搏输出量在基线期和Mitral TEER术后无显著差异(P = 0.7798)。成功进行Mitral TEER后,左心房功能在极早期就得到改善。二维斑点追踪超声心动图可能有助于我们了解术后即刻左心房功能的变化。