Left Atrial Remodeling in Response to Aortic Valve Replacement: Pathophysiology and Myocardial Strain Analysis.
Matteo LisiMaria Concetta PastoreAlessio FiorioMatteo CameliGiulia Elena MandoliFrancesca Maria RighiniLuna CavigliFlavio D'AscenziMarta FocardiAndrea RubboliGianluca CampoSergio MondilloMichael Y HeneinPublished in: Life (Basel, Switzerland) (2022)
Severe aortic stenosis (AS) is the most common valve disease in the elderly and is associated with poor prognosis if treated only medically. AS causes chronic pressure overload, concentric left ventricular (LV) hypertrophy, myocardial stiffness, and diastolic dysfunction. This adverse remodeling also affects the left atrium (LA), which dilates and develops myocardial fibrosis, with a reduction in intrinsic function and a consequent high risk of the development of atrial fibrillation. Speckle-tracking echocardiography is able to detect myocardial dysfunction before other conventional parameters, such as LV ejection fraction, and also predict clinical outcomes. This review aims at describing LV and LA remodeling in AS and before and after aortic valve replacement and the usefulness of myocardial strain analysis in this clinical setting.
Keyphrases
- aortic stenosis
- left ventricular
- aortic valve replacement
- left atrial
- transcatheter aortic valve implantation
- ejection fraction
- poor prognosis
- hypertrophic cardiomyopathy
- mitral valve
- cardiac resynchronization therapy
- heart failure
- acute myocardial infarction
- atrial fibrillation
- transcatheter aortic valve replacement
- aortic valve
- long non coding rna
- oxidative stress
- catheter ablation
- early onset
- pulmonary artery
- pulmonary embolism
- pulmonary arterial hypertension
- acute coronary syndrome
- vena cava