Preoperative left atrial size and functions are predictors of left atrial reverse remodelling after mitral valvuloplasty for myxomatous mitral valve disease in dogs

Abstract

ObjectivesThe objective of this study was to determine alterations in left atrial size, function, and determinants of left atrial reverse remodelling (LARR) after mitral valvuloplasty (MVP) in dogs with myxomatous mitral valve disease (MMVD). AnimalsThirty-seven dogs undergoing MVP. Materials and MethodsEchocardiographic parameters, including left atrial (LA) strain, were evaluated at baseline, during the early postoperative period (within two weeks), and at one and three months postoperatively. Patients were divided into two groups based on the attainment of LARR, defined as a left atrial to aortic root ratio (LA:Ao) < 1.6 at three months. The predictors of LARR were analysed using univariate logistic regression analysis. ResultsLA:Ao significantly decreased in the early postoperative period (median 1.68; lower and upper quartile 1.54–1.92) compared to baseline (2.41; 2.00–2.80), with a further significant reduction observed at three months (1.46; 1.34–1.63). LARR was achieved in 27 (73%) patients. Baseline LA:Ao was higher, and peak atrial longitudinal strain (PALS) and peak atrial construction strain (PACS) were lower in the non-LARR group than in the LARR group. Among the baseline parameters, PACS was the strongest predictor of LARR (area under the curve, 0.837). ConclusionsFollowing MVP, the LA size decreased in the early postoperative period and continued to decrease over three months of follow-up. A low PACS score was the most reliable predictor of inadequate LARR. Further studies are necessary to determine the relationship between LARR, prognosis, and the optimal timing for surgical intervention.