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Left atrial function in patients with rheumatic mitral stenosis: addressing prognostic insights beyond atrial fibrillation prediction.
Figueiredo, Fernanda de Azevedo; Esteves, William Antonio M; Hung, Judy; Gomes, Nayana Flamini Arantes; Taconeli, Cesar Augusto; Pantaleão, Alexandre Negrão; de Oliveira, Matheus Assunção Rabello; de Magalhães, Silvio Mendes; Chavez, Luz Marina Tacuri; Tan, Timothy C; Bhat, Aditya; Levine, Robert A; Nunes, Maria Carmo Pereira.
Afiliación
  • Figueiredo FA; Postgraduate Program of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Esteves WAM; Postgraduate Program of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Hung J; Hospital das Clínicas, School of Medicine,Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Gomes NFA; Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, MA 02114, USA.
  • Taconeli CA; Postgraduate Program of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Pantaleão AN; Hospital das Clínicas, School of Medicine,Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • de Oliveira MAR; Department of Statistics, Universidade Federal do Paraná, Curitiba Rua Cel. Francisco Heráclito dos Santos, 100 Centro Politécnico - Jardim das América sEdifício do Setor de Ciências Exatas, 81531-980, Curitiba, PR, Brazil.
  • de Magalhães SM; Hospital das Clínicas, School of Medicine,Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Chavez LMT; Hospital das Clínicas, School of Medicine,Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Tan TC; Hospital das Clínicas, School of Medicine,Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Bhat A; Postgraduate Program of Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, MG 30130 100, Brazil.
  • Levine RA; Department of Cardiology, Blacktown Hospital, Blacktown Road, Blacktown, Sydney, NSW 2148, Australia.
  • Nunes MCP; Department of Cardiology, Blacktown Hospital, Blacktown Road, Blacktown, Sydney, NSW 2148, Australia.
Eur Heart J Imaging Methods Pract ; 2(2): qyae067, 2024 Apr.
Article en En | MEDLINE | ID: mdl-39224865
ABSTRACT

Aims:

Rheumatic mitral stenosis (MS) frequently leads to impaired left atrial (LA) function because of pressure overload, highlighting the underlying atrial pathology. Two-dimensional speckle tracking echocardiography (2D-STE) offers early detection of LA dysfunction, potentially improving risk assessment in patients with MS. This study aims to evaluate the predictive value of LA function assessed by 2D-STE for clinical outcomes in patients with MS. Methods and

results:

Between 2011 and 2021, patients with MS underwent LA function assessment using 2D-STE, with focus on the reservoir phase (LASr). Atrial fibrillation (AF) development constituted the primary outcome, with death or valve replacement as the secondary outcome. Conditional inference trees were employed for analysis, validated through sample splitting. The study included 493 patients with MS (mean valve area 1.1 ± 0.4 cm2, 84% female). At baseline, 166 patients (34%) had AF, with 62 patients (19%) developing AF during follow-up. LASr emerged as the primary predictor for new-onset AF, with a threshold of 17.9%. Over a mean 3.8-year follow-up, 125 patients (25%) underwent mitral valve replacement, and 32 patients (6.5%) died. A decision tree analysis identified key predictors such as age, LASr, severity of tricuspid regurgitation (TR), net atrioventricular compliance (C n), and early percutaneous mitral valvuloplasty, especially in patients aged ≤49 years, where LASr, with a threshold of 12.8%, significantly predicted adverse outcomes.

Conclusion:

LASr emerged as a significant predictor of cardiovascular events in this MS cohort, validated through a decision tree analysis. Patients were stratified into low- or high-risk categories for adverse outcomes, taking into account LASr, age, TR severity, and C n.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Imaging Methods Pract Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Imaging Methods Pract Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido