Document Detail


Influence of left atrial function on Doppler transmitral and pulmonary venous flow patterns in dilated and hypertrophic cardiomyopathy: evaluation of left atrial appendage function by transesophageal echocardiography.
MedLine Citation:
PMID:  8553998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Information regarding the relation of left atrial (LA) function to transmitral and pulmonary venous (PV) flow is limited. Using transesophageal echocardiography, we analyzed this relation in 23 patients with dilated cardiomyopathy (DCM) and 25 patients with hypertrophic cardiomyopathy (HCM). Left atrial appendage (LAA) function was assessed as a substitute for overall LA function. Transmitral and PV flow-velocity variables, the LAA emptying flow velocity (LAA-A), and the LAA ejection fraction (LAA-EF) were determined. Each patient group was divided into two subgroups with a normal ( < 15 mm Hg) or elevated ( > or = 15 mm Hg) mean pulmonary wedge pressure (PWP). Transmitral and PV flow patterns as well as LA function were similar in the two subgroups with a normal PWP (11 patients with DCM and 14 patients with HCM). For the subgroups with an elevated PWP, however, the peak velocity ratio of the early filling wave (E) to atrial contraction wave (A) was higher in DCM patients (n = 12) than in HCM patients (n = 11) (2.1 +/- 0.7 vs 1.3 +/- 0.2; p < 0.01). This difference mostly resulted from a lower A velocity in the DCM group than in the HCM group (30 +/- 10 cm/sec vs 43 +/- 7 cm/sec; p < 0.05). In addition, the reverse flow velocity at atrial contraction in the PV was lower in the DCM group than in the HCM group (19 +/- 8 cm/sec vs 37 +/- 8 cm/sec; p < 0.01). These findings were associated with poorer LA systolic function in the DCM group (LAA-A, 35 +/- 13 cm/sec vs 60 +/- 11 cm/sec; LAA-EF, 37% +/- 12% vs 55% +/- 15%, p < 0.05, respectively). Our data suggest that a restrictive transmitral flow pattern develops more easily in DCM than in HCM because LA dysfunction is present in DCM, and that LA contractility plays an important role in determining the atrial contraction wave of transmitral and PV flows with elevated LA pressure.
Authors:
T Ito; M Suwa; Y Hirota; Y Otake; A Moriguchi; K Kawamura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  131     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-02-20     Completed Date:  1996-02-20     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  122-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Osaka Medical College, Japan.
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MeSH Terms
Descriptor/Qualifier:
Atrial Function, Left*
Blood Flow Velocity
Blood Pressure
Cardiac Output
Cardiomyopathy, Dilated / physiopathology*,  ultrasonography
Cardiomyopathy, Hypertrophic / physiopathology*,  ultrasonography
Diastole
Echocardiography, Doppler*
Echocardiography, Transesophageal*
Female
Heart Rate
Heart Septum / physiopathology,  ultrasonography
Humans
Male
Middle Aged
Mitral Valve / physiopathology*,  ultrasonography
Myocardial Contraction
Observer Variation
Pulmonary Veins / physiopathology*,  ultrasonography
Pulmonary Wedge Pressure
Regional Blood Flow
Reproducibility of Results
Systole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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