Document Detail


Impact of left ventricular diastolic dysfunction on left atrial volume and function: a volumetric analysis.
MedLine Citation:
PMID:  19828485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Diastolic dysfunction may result in elevation of left ventricular (LV) and atrial pressures, resulting in left atrial (LA) remodelling. We examined the effects of LV diastolic dysfunction on LA volume and function.
METHODS AND RESULTS: We measured LA volume and function in 83 patients with normal LV systolic function. The LV diastolic function grade was defined using traditional Doppler measures of diastolic function. LA volumes were measured using the ellipsoid method. Maximum LA volume (Vol(max)) was indexed to the body surface area(.) The passive filling, conduit and active emptying volumes were estimated and corrected for indexed LA Vol(max). Indexed LA Vol(max) was strongly associated with LV diastolic function grade (Spearman P < 0.01, r(s) = 0.79). An indexed LA Vol(max) > 19.7 mL/m(2) predicted diastolic dysfunction with 97% sensitivity and 96% specificity. Compared with normal controls, corrected passive filling and conduit volumes were lower, and corrected active emptying volume was higher in patients with Grade I diastolic dysfunction (0.38 vs. 0.51, P = 0.02; 1.65 vs. 3.29, P < 0.001; 0.59 vs. 0.44, P = 0.001), resulting in a similar corrected total emptying volume (0.97 vs. 0.96, P= ns). Patients with higher grades of diastolic dysfunction, however, had lower corrected passive filling, conduit, active, and total emptying volumes.
CONCLUSION: LA remodelling occurs in patients with LV diastolic dysfunction and LA volume expressed the severity of diastolic dysfunction. Initially, the LA compensates for changes in LV diastolic properties by augmenting active atrial contraction. As the severity of diastolic dysfunction increases, this compensatory mechanism fails as atrial mechanical dysfunction sets in, resulting in lower total atrial emptying volume.
Authors:
Swee Guan Teo; Hilda Yang; Ping Chai; Tiong Cheng Yeo
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Publication Detail:
Type:  Journal Article     Date:  2009-10-13
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  11     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-05     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  38-43     Citation Subset:  IM    
Affiliation:
Department of Cardiology, National University Health System, 5 Lower Kent Ridge Rd., Singapore, Singapore, 119074. swee_guan_teo@nuhs.edu.sg
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Analysis of Variance
Atrial Function, Left*
Case-Control Studies
Echocardiography
Female
Heart Atria / pathology,  ultrasonography*
Hemodynamics
Humans
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Statistics, Nonparametric
Stroke Volume
Ultrasonography, Doppler
Ventricular Dysfunction, Left / pathology,  ultrasonography*

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