A1 Refereed original research article in a scientific journal

Structural and functional abnormalities of left-sided cardiac chambers in Barlow's disease without significant mitral regurgitation




AuthorsMeucci, Maria Chiara; Mantegazza, Valentina; Wu, Hoi W.; van Wijngaarden, Aniek L.; Garlaschè, Anna; Tamborini, Gloria; Pepi, Mauro; Bax, Jeroen J.; Ajmone Marsan, Nina

PublisherOxford University Press

Publication year2024

JournalEHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging

Journal name in sourceEuropean heart journal. Cardiovascular Imaging

Journal acronymEur Heart J Cardiovasc Imaging

Volume25

Issue9

First page 1296

Last page1305

ISSN2047-2404

eISSN2047-2412

DOIhttps://doi.org/10.1093/ehjci/jeae121

Web address https://academic.oup.com/ehjcimaging/advance-article/doi/10.1093/ehjci/jeae121/7665228?searchresult=1

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/393473970


Abstract

Aims

To explore the presence of left ventricular (LV) and left atrial (LA) morphological and functional abnormalities in patients with Barlow's disease (BD) without significant mitral regurgitation (MR) and to investigate whether these abnormalities may predict MR progression.

Methods and results

Consecutive patients with BD were retrospectively identified from two tertiary centers; those with MR graded from trivial to mild-to-moderate were selected and matched with healthy controls in a 1:1 ratio. Conventional and speckle-tracking echocardiographic data were collected. The development of moderate-to-severe or greater MR was evaluated on follow-up echocardiograms.Patients with BD (n=231) showed increased LV dimensions and indexed LV mass (LVMi) in comparison to controls (p<0.001); LV remodeling worsened with higher MR severity and was accompanied by an increased prevalence of eccentric LV hypertrophy (eLVH). Moreover, BD patients had larger LA volumes and more impaired LA reservoir strain versus controls (p<0.001), while LV strain was similar between the two groups. Multivariable linear regression analyses in the overall population identified BD and MR grade as independent predictors of remodeling markers (LV dimensions, LVMi and LA volume), and BD as independent correlate of LA strain.MR progression was observed in 51 BD subjects (out of 170 patients with available follow-up). On Cox regression analysis, age, eLVH, mild-to-moderate MR and mitral annular disjunction (MAD) emerged as independent predictors of MR progression.

Conclusions

BD patients without significant MR show early LV and LA remodeling, together with reduced LA strain. MR progression was associated with eccentric LV remodeling, MAD, and MR severity.


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Funding information in the publication
None declared.


Last updated on 2025-06-05 at 09:39