Document Detail

Left Atrial Function in Patients with Mitral Valve Regurgitation.
MedLine Citation:
PMID:  25217651     Owner:  NLM     Status:  Publisher    
The purpose of this study was to assess left atrial (LA) function and myocardial mechanics in patients with degenerative mitral regurgitation (MR). Eighty patients with degenerative MR and 20 controls were included prospectively. LA and right atrial (RA) volumes were measured with three-dimensional transthoracic echocardiography at three phases of the cardiac cycle as maximal volume (LAVmax/RAVmax ), minimal volume (LAVmin/ RAVmin) and volume before atrial contraction (LAVpre-A/ RAVpre-A). From these volumes, active stroke volume (SV), distensibility and emptying fraction (EF) were calculated. LA strain and strain rate were measured with vector velocity imaging on 4-chamber and 2-chamber views. Left ventricular (LV) filling pressures were increased in patients with severe MR (E/E' 16±4 vs. 10±3 in controls). LAVmax, LAVmin and LAVpre-A all increased with increasing MR volume. As LAVpre-A increased, both LA total SV (r=0.68, p<0.001) and passive filling volume (r=0.76, p<0.001) increased. LA active SV increased with LAVpre-A up to a certain point upon which it decreased despite further increased LAVpre-A (r=0.53, p<0.001). LA late negative strain decreased with increasing MR volume. A positive correlation existed between LA late negative strain and the LA active EF (r=0.55, p<0.001). In contrast, RA functions were comparable between groups. In conclusion, LA contractility (active SV) increased in response to an increase in LA preload (LAVpre-A) up to a point beyond which LA contractility (active SV) decreased. Whether this is due to working of the LA at the descending limb of the Frank-Starling curve or mainly due to changes in afterload still remains unclear.
Ben Ren; Lotte de Groot-de Laat; Marcel L Geleijnse
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-12
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  -     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014, American Journal of Physiology - Heart and Circulatory Physiology.
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