Left atrial strain assessment in mitral regurgitation: a systematic review.
Omar Dabash, Zaid Yacoub, Salem Abu Al-Burak et al.
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In 30 seconds
This systematic review evaluated left atrial strain (LAS) in patients with mitral regurgitation (MR) to assess its prognostic value and response to interventions. The review found that left atrial reservoir strain (LASr) was significantly reduced in MR patients compared to controls, with LASr <35% predicting cardiovascular events and LASr ≤15% in secondary MR predicting mortality. The study highlights the importance of LAS as a marker of atrial dysfunction.
Key findings
- Left atrial reservoir strain (LASr) was reduced in MR patients compared to controls across all aetiologies.
- LASr <35% predicted cardiovascular events, while LASr ≤15% in secondary MR predicted mortality.
- Secondary MR showed more severe LAS impairment than primary MR due to combined volume and pressure overload.
- Patients with ≥15% LASr improvement post-intervention had significantly lower all-cause mortality and heart failure hospitalisation.
Why it matters
Understanding left atrial strain provides clinicians with a sensitive measure of atrial dysfunction in mitral regurgitation, potentially allowing for earlier intervention and improved patient outcomes. This could enhance risk stratification and management strategies in affected patients.
What to keep in mind
Most supporting evidence is retrospective and derived from single-centre studies, limiting generalizability.