Left atrial function may mitigate the effect of mitral regurgitation on right chambers in patients with severe aortic valve stenosis

Abstract Introduction Left atrial (LA) function has been associated to right chambers hemodynamics in the context of mitral valve regurgitation (MR). However, this physiological interplay between left function, and ventricular (RV) parameters not yet clarified patients with aortic stenosis (AS). Aim study To assess combination LA different MR grades performance pulmonary non-invasive status severe AS using an advanced automated echocardiographic approach. Methods Consecutive referred our institution were analyzed. Mitral was classified according integrative guideline-based criteria. 2D speckle tracking echocardiography analysis conducted measure peak longitudinal strain (PALS) free wall strain, (RVFWS) Tomtec Arena, version TTA2 41.00, dedicated LV/LA/RV option (Tomtec, Unterschlei heim, Germany). All conventional indexes also measured: TAPSE, S'- TDI, fractional area change, systolic artery pressure (sPAP). We featured 3 groups based on grade function: (a) no/mild preserved PALS (above median); (c) >mild reduced PALS; (b) remaining low or high PALS. Results A total 102 formed cohort: age 82±9, 47% female, mean left-ventricular-ejection-fraction 56%±12, more than mild present 24% patients, 19±10%, sPAP 38±12 mmHg, RVFW 21±6%, RVFW/sPAP 0.62±0.25. The subgroups presented similar sex distribution. Right significantly worsened moving from group (c); decreased 25±5 19±7 17±5% (c), p<0.001; increased 34±9 39±12 47±13 mmhg 0.76±0.21 0.54±0.23 0.39±0.11 p<0.001. Patients symptomatic (NYHA class III/IV increase 40% a 63% 80% c, p=0.006). When added grade, logistic regression analysis, provided incremental prediction all (p<0.01). Conclusion This highlights that is symptoms RV impairment AS. These preliminary results suggest may modulate adverse effects AS-MR by preventing/delaying development hypertension dysfunction. Funding Acknowledgement Type funding sources: None.