Prediction of Left Atrial Fibrosis With Speckle Tracking Echocardiography in Mitral Valve Disease: A Comparative Study With Histopathology

Background and Objectives: Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. How ever, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle track ing echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery. Subjects and Methods: Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measure ments were repeated within 30 days after surgery (n=50) and 1-year later (n=39). Results: Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was in dependent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confi dence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant. Conclusion: Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease. (Korean Circ J 2012;42:311-318)