Peak atrial longitudinal strain (PALS) was evaluated in 43 patients with severe isolated AS and normal EF (56.6 ¡À 3.8 % ) and no obstructive coronary artery disease candidates for AVR, pre-operatively and then 40 days and 3 months after surgery. Results were compared with those from 34 age- and gender-matched healthy controls.
LVEF remained unchanged and LV mass regressed after AVR. Global PALS was reduced pre-operatively and increased 40 days after surgery (p = 0.002) and showed only a slight further increase at 3 months follow-up (p < 0.0001). Indexed LA volume was increased before surgery, but significantly fell 40 days after surgery (p < 0.0001) and showed only a slight further reduction after 3 months (p < 0.0001). Trans-aortic mean gradient change after surgery was the only independent predictor of the recovery of LA size and function.
AVR reverses LA abnormalities and regains normal atrial function, a behavior which is directly related to the severity of pre-operative LV outflow tract obstruction. Early identification of LA size enlargement and functional disturbances might contribute to better patient's recruitment for AVR.