The Egyptian Heart Journal | 2019
Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics
Abstract
Global left atrial strain (LA) has been used as a novel assessment tool to evaluate left atrial function. However, not much has been investigated to study the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis on global LA strain. We studied the relationship between global left atrial (LA) strain and severe mitral stenosis and the effect of BMV on LA strain. A total of 29 patients satisfying the criteria for severe mitral stenosis underwent balloon mitral valvotomy (67% females; mean age, 39.53\u2009±\u200911.78\u2009years). Global left atrial strain was assessed by speckle tracking echocardiography before and after valvuloplasty. Global LA strain was impaired in patients with severe mitral stenosis and improved 24–48\u2009h following BMV (13.4\u2009±\u2009.75% vs 17.37\u2009±\u20096.95%, p\u2009<\u20090.001). There was a significant decrease in mitral mean gradient (MMG) (16.94\u2009±\u20096.62\u2009mmHg vs 8.19\u2009±\u20094.01\u2009mmHg, p\u2009<\u20090.001) and systolic pulmonary artery pressure (sPAP) (47.84\u2009±\u20099.07\u2009mmHg vs 36.88\u2009±\u20097.69\u2009mmHg, p\u2009<\u20090.001) after BMV. Mitral valve area (MVA) (1.045\u2009±\u20090.17\u2009cm2 vs 1.94\u2009±\u20090.22\u2009cm2, p\u2009<\u20090.001) significantly increased after BMV. Results were compared with 30 age- and sex-matched healthy controls. Global LA strain can be taken as an indicator of left atrial function, and its improvement following valvotomy may be taken as a good indicator of successful BMV.