Changes in Left Atrial Function in Patients with Acute St-Elevation Myocardial Infarction and Secondary Mitral Insufficiency Assessed by Cardiac MRI - ICCAD 2017 - The 12th International Congress on Innovations in Coronary Artery Disease , 15-17 October, 2017 Venice, Italy

Paulius Bucius ¹ Laura Urbonaite ¹ Agnieta Stabinskaite ¹ Audrone Vaitiekiene ¹ Rimantas Benetis ^2,3 Remigijus Zaliunas ¹ Lina Jankauskaite ⁴ Tomas Lapinskas ¹

¹Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences
²Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences
³Institute of Cardiology, Lithuanian University of Health Sciences
⁴Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences

Background: Left atrial (LA) function during acute myocardial infarction (MI) is affected by acute ischemia of atrial myocardium. Meanwhile, mitral regurgitation (MR) stimulates cardiac remodeling and is associated with LA failure, atrial fibrillation and cardiac death. This study aimed to evaluate LA myocardial deformation using cardiac magnetic resonance feature tracking (CMR-FT) in patients with acute ST-segment elevation MI (STEMI) and secondary MR.
Methods and results: Twenty patients were consecutively enrolled into the study if they presented with first STEMI and were treated with primary coronary intervention (PCI). According to the presence of MR patients were divided into two groups: MR(+) and MR (-) and underwent CMR with a 1.5 T MRI scanner (Siemens Magnetom Aera, Erlangen, Germany). Total LA strain (ε_s), passive LA strain (ε_e), and active LA strain (ε_a) were obtained. Additionally, total, passive and active strain rates (SR_s, SR_e, and SR_a) were calculated. LA volumetric and functional parameters were similar in both groups. All LA strain values were significantly higher in patients with MR: ε_s (27.67 ± 10.25 for MR(-) vs. 32.80 ± 6.95 for MR(+); p = 0.01), ε_e (15.29 ± 7.30 for MR(-) vs. 19.22 ± 6.04 for MR(+); p = 0.01) and ε_a (12.38 ± 4.23 for MR(-) vs. 14.44 ± 5.19 for MR(+); p = 0.03). Only SR_e significantly increased in patients with MR (-0.57 ± 0.24 for MR(-) vs. -0.70 ± 0.20 for MR(+); p = 0.01).
Conclusion: LA reservoir, passive and active strain values are significantly higher in patients with MR. Only peak early negative LA strain rate substantially increases during secondary MR.