Left atrial function and remodelling in aortic stenosis

Eur J Echocardiogr. 2011 Apr;12(4):299-305. doi: 10.1093/ejechocard/jer006.


Aims: The present study sought to determine the relationship between left atrial (LA) volume (structural changes) and LA function as assessed by strain rate imaging in patients with aortic stenosis (AS).

Methods and results: The study consisted of a total of 64 consecutive patients with severe AS (<1 cm&sup2;) and 20 healthy control subjects. The phasic LA volumes and function (tissue Doppler-derived strain) were assessed in all patients. As compared with healthy controls, all strain-derived parameters of LA function were reduced in patients with AS. Conversely, only indexed LA passive volume (increased) (7.6 ± 3.8 vs. 10.5 ± 5.1 ml/m&sup2;, P= 0.02) and LA active fraction (decreased) (43 ± 6.7 vs. 31 ± 13.3%, P< 0.001) (volume-based parameters) were significantly different between AS and controls. In AS, LA volume-derived function parameters were poorly correlated with LA strain parameters. In fact, by multivariable analysis, no LA phasic strain parameters emerged as independently associated with LA phasic volume parameters.

Conclusions: In AS, changes in LA function did not parallel changes in LA size. Furthermore, the increase in LA volume does not necessarily reflect the presence of intrinsic LA dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / physiopathology*
  • Atrial Function, Left*
  • Case-Control Studies
  • Chi-Square Distribution
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Ultrasonography, Doppler, Color / methods*