CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 5, November/December 2023 296 AFRICA Multivariate regression analysis was done to assess factors affecting the LA function. The model showed statistical significance and explained 87.9% of the variance determining LA function. LAVImin, LAVImax and MVA were the variables showing statistically significant association with LA function (p = 0.000). Two-dimensional (2D) echocardiography showing dynamic changes in LA area during the cardiac cycle, and an assessment of LA volume by the biplane area–length method in the patients are presented in Fig 2. Discussion RHD is one of the most common causes of cardiovascular morbidity and mortality.19 The mitral valve is frequently involved in MS, and it is the most prevalent valve lesion in patients with chronic RHD.20 LA functional impairment has been reported to be associated with rheumatic MS. However, few studies have correlated LA function with the MVA. In our study, LA functional parameters were assessed by echocardiography and tested for possible correlation with the MVA. In addition, the differences between patients in sinus rhythm and AF concerning these parameters together with the MVA were evaluated. This study included 81 patients with rheumatic MS, with 71.6% of them having associated MR. The study patients had a mean age of 47.40 ± 12.30 years, and showed female predominance. Similarly, the study of Fu et al.21 reported that mixed MS and MR lesions were seen in 73.2 and 79.3% of their study groups with rheumatic mitral valve disease. They also reported a female predominance in MS cases. Similar gender distribution was also reported elsewhere.22-24 The echocardiography measurements of the study patients revealed that the mean MVA was 1.29 ± 0.48 cm2. Comparison among patients with different grades of MS (mild, moderate and severe) with regard to the echocardiographic findings showed statistically significant/highly significant differences in Fig. 2. A: LA size displayed in the four-chamber view in which LA has been maximised. B: LA size displayed in the four-chamber view in which LA has been minimised. C: LA size displayed in the two-chamber view in which LA has been maximised. D: LA size displayed in the two-chamber view in which LA has been minimised. A C B D
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