Document Detail


Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function.
MedLine Citation:
PMID:  22543839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Left atrial (LA) maximum volume (LAV(max)) is an indicator of left ventricular (LV) diastolic function. However, LAV(max) is also influenced by systolic events, whereas the LA minimum volume (LAV(min)) is directly exposed to LV pressure. The authors hypothesised that LAV(min) may be a better correlate of LV diastolic function than LAV(max).
DESIGN: Cross-sectional.
SETTING: University hospital.
PATIENTS: 357 participants from a community-based cohort study.
METHODS: LA volumes and reservoir function, measured as total LA emptying volume (LAEV) and LA emptying fraction (LAEF), were assessed by real-time three-dimensional echocardiography. LV diastolic function was assessed by trans-mitral early (E) and late (A) Doppler velocities and mitral early diastolic velocity by tissue-Doppler (e'). LV systolic function was assessed by LV ejection fraction (LVEF) and global longitudinal strain (GLS) by speckle-tracking.
RESULTS: LAV(min) significantly increased with worsening diastolic dysfunction (p<0.001), whereas the increase in LAV(max) was less pronounced (p=0.07). LAEV and LAEF decreased with worsening diastolic dysfunction (both p<0.001). In linear regressions, LAV(min) and LAV(max) were significant predictors of E/e', with higher parameter estimates for LAV(min). In multivariate models, LAV(min) resulted strongly associated with E/e' (β=0.45, p<0.001), whereas LAV(max) was not (β=-0.16, p=0.08). LA reservoir function was better associated with GLS than LVEF. In multivariate analyses, GLS was significantly associated with LAV(max) (β=-0.15, p=0.002), LAEV (β=-0.37, p<0.001) and LAEF (β=-0.28, p<0.001) but not with LAV(min).
CONCLUSIONS: LAV(min) is a better correlate of LV diastolic function than LAV(max). The impact of LV longitudinal systolic function on LA reservoir function might explain the weaker relation between LAV(max) and LV diastolic function.
Authors:
Cesare Russo; Zhezhen Jin; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  98     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-30     Completed Date:  2012-06-28     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  813-20     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Columbia University, College of Physicians & Surgeons, 630 West 168th Street, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Volume / physiology*
Cross-Sectional Studies
Diastole
Echocardiography, Doppler
Echocardiography, Three-Dimensional
Female
Follow-Up Studies
Heart Atria / physiopathology*,  ultrasonography
Humans
Incidence
Male
New York / epidemiology
Prognosis
Stroke Volume
Systole
Ventricular Dysfunction, Left / diagnosis,  epidemiology,  physiopathology*
Ventricular Function, Left / physiology*
Ventricular Pressure
Grant Support
ID/Acronym/Agency:
R01 NS036286/NS/NINDS NIH HHS; R01 NS36286/NS/NINDS NIH HHS; R37 NS029993/NS/NINDS NIH HHS; R37 NS29993/NS/NINDS NIH HHS
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