Abstract
p<0.001) and LA strain (r=−0.51 p<0.001). While 50% of the patients had reduced E/e’ or improved LA strain, only 26% (51/195) had normalised LAV. Compared with surgery, successfully reducing E/e’ by medical therapy was less effective in reducing LAV (−9.0ml vs−32.6ml, p<0.001) but produced similar improvement in LA strain (5.8%vs 3.9%, p=0.48), contributed by both LA conduit and contractile function. Having normal or improved E/e’ at follow-up was not associated with normalisation of LAV (RR=1.29 p=0.326 and RR=1.22 p=0.421 respectively), but was associated with normalisation of LA strain (RR=2.04 p=0.011 and RR=1.86 p=0.017 respectively) independently of changes in LAV. Conclusions: Lowering LV filling pressure reduces but rarely normalises LAV. However, its effect in normalising LA function is significant and independent of changes in LAV.
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