0084: Left atrial systolic dysfunction and prognosis in severe aortic stenosis

IntroductionLeft atrial (LA) size has recently emerged as a prognostic factor in patients with valvular heart disease.Aim of the studyIs to determine the utility of LA systolic function in patients with aortic stenosis (AS)Methodswe studied 178 patients (mean age 79.6±0.6 years) with severe AS who underwent 2D echocardiography for the assessment of left ventricular (LV) and right ventricular (RV) function, LA size, aortic valve morphology and gradients. Peak LA strain (pLAS) measured by 2D speckle tracking echocardiography (STE) was used to evaluate LA contractility. A pLAS <23% -the indicated referral limit in normal population - was considered as an index of impaired LA contractility.ResultsA pLAS ≤23% was very common in patients with AS (n=139, 79%). Patients with reduced pLAS had greater LA volume (52.9±15.7 vs 36.6±7.8ml/m², p<0.0001), reduced LV ejection fraction (54.2±12.8 vs 61.5±7.7%, p=0.001), reduced TAPSE (19.9±4.3 vs 22.3±4.0mm, p=0.003), a more severe aortic stenosis (aortic surface: 0.40±0.09 vs 0.48±0.13 cm²/m², p<0.0001) and higher lnNT-proBNP (7.6±1.3 vs 6.1±1.4, p<0.0001) levels. The main factors associated with pLAS were: left ventricular global longitudinal strain, lnNT-proBNP, indexed LA volume, and TAPSE (β=–0.58, – 0.56, – 0.51 and – 0.43 respectively; all p