Left Atrial Function before and after Aortic Valve Replacement in Aortic Stenosis patients (Strain Imaging Study) | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 47, Volume 100, Issue 1, July 2025, Page 2858-2864 PDF (627.37 K) | ||||
| DOI: 10.21608/ejhm.2025.440595 | ||||
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| Abstract | ||||
| Background: Aortic stenosis (AS) is increasingly prevalent with aging populations and poses a growing health concern. Even initially mild AS tends to progress, resulting in worsening obstruction. As AS advances, diastolic dysfunction develops, impairing the heart's ability to relax and fill, which is reflected in left atrial (LA) functions. These changes can exacerbate symptoms, promote structural remodeling, and elevate risks for adverse cardiovascular events. Objectives: This study aimed to evaluate LA mechanical function before and after aortic valve replacement (AVR) among patients who had severe AS. Patients and methods: This prospective study involved 31 patients with severe AS scheduled for AVR at Menoufia University Hospital and the National Heart Institute. All participants underwent comprehensive echocardiographic assessment, including LA strain imaging, both immediately before and three to seven days following AVR. Results: The cohort comprised 20 males (64.5%) and 11 females (35.5%), aged 38–74 years. The mean aortic valve gradient decreased significantly from 50 ± 5.73 mmHg preoperatively to 11.1 ± 2.12 mmHg postoperatively (P<0.001). All indices of LA mechanics showed significant postoperative improvement, especially LA reservoir function, which increased from 18 ± 5.72% to 20.7 ± 6.68% (P<0.001). Regression analysis showed LA reservoir function depended on hypertension, AS severity, LA volume, and LV filling pressure. LA conduit and contractile functions were linked to LV filling pressures, with conduit function also influenced by AS severity and contractile function by LA volume. Conclusions: Preoperative LA strain indices are strongly associated with AS severity and diastolic dysfunction. LV filling pressures, LA volume index, and baseline LA strain are key determinants of LA function after AVR. | ||||
| Keywords | ||||
| Left Atrial Function; Aortic Valve Replacement; Aortic Stenosis | ||||
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