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32. Cardiovascular Nursing
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34. Public Health and Health Economics
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Value of atrial strain as a an estimate of rheumatic mitral stenosis severity
Session:
CO 17 - Doença Valvular
Speaker:
Filipa Castro
Congress:
CPC 2018
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.3 Valvular Heart Disease – Diagnostic Methods
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Filipa Castro; Mário Lourenço; Olga Azevedo; Bebiana Faria; Isabel Oliveira; António Lourenço
Abstract
<p><strong>Introduction:</strong> Rheumatic mitral stenosis (RMS) causes left atrial (LA) geometrical changes, due to an increased pressure and volume, and, consequently, deterioration of its systolic function. LA <em>strain</em> analysis by <em>speckle tracking</em> emerges as a gold standard for evaluation of atrial myocardial deformation, particularly peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS) and contraction strain index (LA CSI). In patients with RMS, PALS and PACS are significantly reduced.<br /> <strong>Aim: </strong>Assess LA function, using PALS, PACS and CSI, in patients with RMS and its relationship with the severity of the RMS.<br /> <strong>Methods:</strong> We included 44 patients with mild to severe RMS, in sinus rhythm. All subjects underwent transthoracic echocardiogram, including evaluation of maximum and medium gradients, anatomical valve area and pressure half time (PHT) and continuity equation. PALS, PACS and LA CSI (PACS/PALS x100) were obtained by speckle tracking. PALS was measured at the end of the reservoir phase and PACS was measured just before the start of the active atrial contractile phase. The average of PALS and PACS were obtained from the 12 LA segments at apical 4 and 2chamber views.<br /> <strong>Results:</strong> Patients were predominantly female (86,4%), with mean age of 59±12 and a low PALS (17.5 ± 7.3) and PACS (9.5±4.9).</p> <p>Maximum and medium gradients were 13.2±7 mmHg and 5.8 ± 4.3 mmHg, respectively.</p> <p>Functional mitral valve area, by PHT was 1.6 ± 0.4 cm2 and by continuity equation was 1.5 ± 0.4 cm2. Mean anatomic mitral valve area was 1.6 ± 0.5 cm2.</p> <p>Medium and maximum gradients and anatomic mitral valve area were correlated with LA CSI (p=0,017 r=0,36; p=0,019 r=0,035; p=0,032 r=0,44, respectively), but not with PALS and PACS (P>0,05). Functional valve area by PHT was correlated with PALS (p=0,03 r=0,44) and by continuity equation was correlated with PALS and PACS (p=0,00 r=0,60; p=0.026 r=0,38, respectively).</p> <p><strong>Conclusion: </strong>Atrial strain parametres correlate with the severity of RMS.</p>
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