Ultrasound assessment of the association between left atrial remodeling and fibrosis in patients with valvular atrial fibrillation: a clinical investigation.

BACKGROUND

Advanced heart failure in patients with valvular atrial fibrillation (VAF) poses a significant threat to human health. Noninvasive assessment of left atrial remodeling in various pathological conditions is instrumental in guiding clinical treatment decisions, evaluating efficacy, and predicting prognosis.

METHODS

The study enrolled 63 patients diagnosed with mitral stenosis (MS), among whom 44 presented concomitant atrial fibrillation (AF) and 19 had sinus rhythm. Left atrial volume and functional parameters were evaluated using real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI) techniques, while left atrial stiffness index (LASI) was calculated accordingly. During surgery, left atrial myocardial specimens were obtained to determine the CVF through histopathological evaluation, reflecting the extent of left atrial myocardial fibrosis. Comparative analysis was conducted between the AF group and the control group regarding left atrial volume, functional parameters, LASI, as well as their correlation with CVF.

RESULTS

(1) Patients with MS combined with AF exhibit larger left atrial volume, decreased strain at all stages, reduced function, and increased stiffness of the left atrium compared to patients in sinus rhythm. (2) LASI was positively correlated with CVF in both the control and AF groups, exhibiting the highest correlation coefficient (p < 0.05).

CONCLUSION

The application of RT-3DE, 2D-STI, and LASI enables effective evaluation of left atrial structure and function changes in patients with VAF. LASI provides a more accurate indication of the extent of myocardial fibrosis.

CLINICAL TRIAL NUMBER: Not applicable.