Usefulness of Atrial Deformation Analysis to Predict Left Atrial Fibrosis and Endocardial Thickness in Patients Undergoing Mitral Valve Operations for Severe Mitral Regurgitation Secondary to Mitral Valve Prolapse
Usefulness of Atrial Deformation Analysis to Predict Left Atrial Fibrosis and Endocardial Thickness in Patients Undergoing Mitral Valve Operations for Severe Mitral Regurgitation Secondary to Mitral Valve Prolapse
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DOI：
10.1016/j.amjcard.2012.10.049
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发表时间：
2013-02-15
影响因子：
2.8
通讯作者：
Mondillo, Sergio
中科院分区：
文献类型：
--
作者：
Cameli, Matteo;Lisi, Matteo;Mondillo, Sergio
心脏手术后发生严重二尖瓣反流(MR)的患者，左房重构和增大伴随着机械应力、细胞肥大和间质纤维化，最终导致左房衰竭。斑点跟踪超声心动图是一种新的非基于多普勒的方法，它可以客观地定量左房心肌的变形，成为左房功能分析的有用工具。我们进行了一项研究，以评估传统的和新的心房指数与超微结构改变的程度之间的关系，这些变化来自接受瓣膜疾病外科手术的重症MR患者。研究人群包括46名患有严重MR的患者，他们在心脏手术前到我们的超声心动图实验室进行诊断性检查。所有受试者通过取所有心房节段的平均值来测量整体峰值心房纵向应变(PALS)。LA组织标本均取自所有患者。用Masson‘s三色染色评价肝纤维化程度。测量左房心内膜厚度。整体PALS与LA心肌纤维化分级呈显著负相关(r=-0.82，P<0.05)。
In patients with severe mitral regurgitation (MR) referred for cardiac surgery, left atrial (LA) remodeling and enlargement are accompanied by mechanical stress, mediated cellular hypertrophy, and interstitial fibrosis that finally lead to LA failure. Speckle tracking echocardiography is a novel non-Doppler-based method that allows an objective quantification of LA myocardial deformation, becoming useful for LA functional analysis. We conducted a study to evaluate the relation between the traditional and novel atrial indexes and the extent of ultrastructural alterations, obtained from patients with severe MR who were undergoing surgical correction of the valvular disease. The study population included 46 patients with severe MR, referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery. The global peak atrial longitudinal strain (PALS) was measured in all subjects by averaging all atrial segments. LA tissue samples were obtained from all patients. Masson's trichrome staining was performed to assess the extent of the fibrosis. The LA endocardial thickness was measured. A close negative correlation between the global PALS and grade of LA myocardial fibrosis was found (r = -0.82, p