The Association Between Left Atrial Strain and Left Ventricular Ejection Fraction in a 3D Heart Model in Patients With Severe Aortic Stenosis

Objectives: Aortic stenosis (AS) is a common valvular disease diagnosed in nearly 3% of adults who are older than 65 years. Echocardiography is the main modality for the diagnosis of an AS. The left atrial (LA) strain can help in a better evaluation of heart failure and predict left-side pressures. Considering that a left ventricular ejection fraction (LVEF) is an important factor for cardiologists regarding better selection of surgery treatment in these patients, the evaluation of the LA strain and LVEF, as well as their association can help physicians in a better evaluation of borderline patients who are asymptomatic with borderline LVEF. Materials and Methods: Atrial mechanics were prospectively evaluated in 43 consecutive patients with severe AS referring to Shahid Rajaee Heart Center (Tehran, Iran), echocardiography laboratory for their regular valve disease follow-ups from July 2018 to February 2019. The LA strain, the LVEF, and their association were analyzed by a 3D heart model. Results: The mean age of patients was 56.6±18.9 years. The LA strain did not have any association with age (P=0.09). In addition, no association was found among LA strains, hypertension, and smoking in patients with severe AS (P>0.05). Finally, the results showed that an LA strain had a significant association with a 3D method of LVEF (P=0.02). Conclusions: In general, an LA longitudinal strain has a significant association with a 3D LVEF in patients with severe AS and can help physicians better evaluate patients with severe AS.