Left atrial strain and distensibility in relation to left ventricular dysfunction and prognosis in aortic stenosis

Background Left atrial (LA) function is increasingly used to assess cardiovascular diseases. Objective We tested the relationship between LA distensibility (Lad), LA strain (Las) and left ventricular dysfunction and prognosis in aortic stenosis (AS). Methods Transthoracic Doppler echocardiography was performed prospectively in 98 consecutive patients with AS (63 with severe, 35 with moderate AS, mean age 77 ± 10 years, 49% women, mean aortic valve area 0.5 ± 0.15 cm 2 , mean LVEF 63 ± 13%). LA volume was calculated by the area-length method in apical four-and two-chamber views, at two points: immediately before mitral valve opening (Vol max) and at mitral valve closure (Vol min). LA distensibility was defined as (Vol max − Vol min) × 100%/Vol min. Las (mean of maximal strain from the 4-2-3 chamber views) was conducted using a dedicated software package, using R-R gating. The end-point was hospitalisation for heart failure and death from any cause. Results Las, Lad, and LA vol/m 2 were significantly correlated to E/A, E/e’, and pulmonary artery systolic pressure (all, P 2 were significantly correlated to comorbidities index (Charlson, Euroscore), LVEF, stroke volume/m 2 , as well as to peak aortic jet velocity (all, P 2 , as well as Charlson index, diabetes, and DTI parameters were associated to events (all, P P P P Conclusion In patients with moderate to severe AS, Lad and LAs are associated with LV diastolic and systolic dysfunction, AS severity, and are independently linked to events.