Российский кардиологический журнал (Nov 2019)
Linear and volumetric parameters of left atrium in patients with isolated aortic stenosis
Abstract
Aim. To study volumetric and linear parameters of the left atrium (LA) in operated and non-operated patients with severe aortic stenosis (AS) in comparison with the control group of a similar age and gender.Material and methods. Eighty-one patients with AS were examined, 49 patients — in the long term after aortic valve replacement (AVR), and 30 patients of similar age and gender — without a heart defect. Echocardiography was performed using an Acuson Sequia 512 ultrasound scanner.Results. The volumetric parameters of LA (LA volume index (LAVI)) and the ratio of the minimum LA with LV volume at this time point (LAVmin/LV) were the most sensitive parameter when evaluating the LV diastolic function in patients with isolated AS when comparing non-operated and operated patients and the control group. The study of association of non-operated AS patients with LAVI (greater than or less than 32 ml/m2) showed only a slight divergence between the Kaplan-Meyer curves with a log-rank test of 0,15. Only the values of the LV ejection fraction (LVEF) differed from parameters of died (n=21) and alive patients at the time of the study (n=60): 61,0 (56,4-69,3)% in alive versus 46,4 (39,1-55,4)% in dead ones (p<0,0001). The time elapsed from the diagnosis to the date of the examination also differed: 0,5 (0,4-11,0) years in alive versus 7,0 (3,0-19,0) years in dead ones (p=0,004). With multiple regression, the highest and statistically significant beta coefficient was found only in LVEF (beta — -0,52, p=0,002).Conclusion. Linear and volumetric parameters of LA slightly associate with the age and gender of operated and non-operated AS patients. These parameters statistically significantly differ in the groups of non-operated AS patients and patients after AVR compared with the control group, including patients without heart disease. The values of linear and volumetric LA parameters in patients with AS after AVR are close to those in the control group.
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