Article ID: CR-25-0183
Background: Although mitral valve repair typically leads to left atrial reverse remodeling, persistent left atrial enlargement is associated with poor prognosis. Factors contributing to postoperative left atrial enlargement remain poorly understood. Left atrial strain analysis may offer supplementary evaluation of left atrial function, complementing conventional volume-based assessments.
Methods and Results: Echocardiographic data of 76 patients who underwent mitral valve repair for primary mitral regurgitation due to leaflet prolapse were retrospectively analyzed. Left atrial volume index and strain parameters were evaluated preoperatively and 1 year postoperatively. Predictors of postoperative left atrial enlargement (left atrial volume index ≥34 mL/m2) were assessed by logistic regression and receiver operating characteristic analyses. Postoperatively, left atrial volume index decreased significantly (from 64.4±23.1 to 36.6±10.5 mL/m2; P<0.01) and there was a significant decline in left atrial strain parameters. Preoperative left atrial early longitudinal strain rate was an independent predictor of postoperative left atrial enlargement (odds ratio 0.076; 95% confidence interval 0.07–0.80; P=0.032), with a receiver operating characteristic curve-derived cut-off of 0.815%/s (area under the curve 70.2%, sensitivity 81.1%, specificity 59.0%).
Conclusions: Left atrial early longitudinal strain rate is an independent predictor of postoperative left atrial enlargement following mitral valve repair, providing valuable prognostic information.
