Abstract 221: Predictors of Left Atrial Fibrosis in Patients With Mitral Valve Disease: Pathologic Validation of Left Atrial Function by Speckle Tracking Image
Background: Left atrial (LA) fibrosis is an important predictor for future development of atrial fibrillation and atrial remodeling. However, non-invasive predictors for LA fibrosis has not been clearly established yet. In this study, we sought to determine non-invasive predictors of LA fibrosis using speckle tracking analysis in patients with severe mitral valve disease who underwent mitral valve surgery.
Methods: Fifty patients who had planned to mitral valve surgery (28 with predominant mitral stenosis and 22 with mitral regurgitation) underwent comprehensive echo-Doppler evaluation. Then average global LA strain were measured as average value of global LA strain in apical 4- and 2-chamber views using speckle tracking analysis (n=17). During operation LA tissues were obtained and then degree of fibrosis (% of fibrosis area) was measured after trichrome staining.
Results: Degree of LA fibrosis was higher in patients with predominant mitral stenosis (36.5±20.4% vs. 20.1±11.0% for mitral regurgitation, p=0.001) and atrial fibrillation (n=32, 33.7±18.0% vs. 21.5±17.8% for sinus rhythm, p=0.025). Degree of fibrosis was significantly correlated with left ventricular end-systolic dimension (β=−0.287, p=0.035) even after controlling for underlying rhythm and predominant disease but LA volume did not significantly correlate with degree of fibrosis (r=0.168, p=0.245). Average LA global strain was significantly correlated with degree of fibrosis (r=−0.550, p=0.022).
Conclusion: Global LA strain measured by speckle tracking image rather than LA volume might better predict degree of LA fibrosis.