INTRODUCTION
Aortic regurgitation (AR) is a clinical status characterized by diastolic blood backflow from aorta to the left ventricle (LV) due to the anomalies of valve cusps and aortic root and/or aortic annulus. (1) Severe chronic AR, by causing volume and pressure overload on left ventricle, is likely to lead to left ventricular enlargement, a decrease in ejection fraction (EF) and processes resulting in death in the long term.
Echocardiography is the most significant diagnostic test in the assessment of aortic regurgitation. Echocardiography allows for the examination of the anatomy of valve cusps and aortic root, the establishment of the diagnosis and severity of aortic regurgitation and the assessment of the LV diameters and functions. (1)
Grading the severity of AR is very important for clinical follow-up and determining an optimal surgical date. Clinical and echocardiographic parameters are used for the grading of AR. In spite of numerous parameters, the severity of AR still remains unclear in some patients. New parameters that will be proposed with current improvements and tools in echocardiographic assessment might provide a supplementary contribution to the grading of AR.
The significance of the left atrium (LA) in cardiovascular performance has been recognized for a long time. In recent years, new visualization techniques that present a supplementary view for the assessment of the left atrium have been introduced. Atrial strain and strain rate analysis, which are obtained by tissue Doppler imaging or two-dimensional speckle tracking echocardiography have been proved to be practical and repeatable for assessing the LA mechanics. (3) In AR, which causes severe volume and pressure overload on LV, LA mechanics can be affected in time in parallel with the elevated LV end-diastolic pressure (LVEDP), and LA strain variations can be illuminating for the grading of AR.
The purpose of this study is to determine whether the LA strain parameters are associated with the severity of aortic regurgitation or not.