In vivo assessment of left atrial contractile performance in normal and pathological conditions using a time-varying elastance model.

Hoit, Brian D.; Shao, Yanfu; Gabel, Marjorie; Walsh, Richard A.

doi:10.1161/01.cir.89.4.1829

Cited by 117 publications

(64 citation statements)

References 35 publications

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“…The LA acts as a reservoir during left ventricular systole, and maintains passive filling during early diastole and active pumping during late diastole. [26][27][28] In patients with LV dysfunction, the LA contribution to LV filling becomes more important. 29,30) In the early stages of LV systolic dysfunction, early ventricular diastolic inflow is decreased, and consequently atrial passive emptying is decreased and atrial active pumping function in late diastole is increased.…”

Section: Discussionmentioning

confidence: 99%

“…33) In an experimental study on six mongrel dogs, isolated atrial or ventricular, and combined dysfunction were created with atrioventricular ablation, and rapid atrial and ventricular pacing. 26,27) In dogs with atrial dysfunction but preserved left ventricular function, cardiac output was maintained within normal ranges because of a compensatory increase in LA conduit function. Also in isolated LV dysfunction, cardiac output was not significantly changed because of the compensatory increase in atrial booster pump function.…”

Section: Discussionmentioning

confidence: 99%

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<b>Value of Left Atrial Function in Predicting Exercise Capacity in Heart Failure With Moderate to Severe Left Ventricular Systolic Dysfunction</b>

et al. 2005

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SUMMARYLeft atrial (LA) function is associated with left ventricular (LV) diastolic filling and cardiac output response to exercise. But the relation between LA function and exercise performance has not been adequately evaluated.The aim of this study was to investigate the relation between LA function and exercise capacity in dilated cardiomyopathy (DCM) with cardiopulmonary exercise testing.Forty-four patients with a left ventricular end-diastolic dimension (LVDd) ≥ 60 mm and an ejection fraction (EF) ≤ 40%, and in normal sinus rhythm were included in this study. Patients were divided into group 1 and group 2 according to their exercise peak oxygen uptake (VO 2 ) (group 1: peak VO 2 >14 mL/kg/min, group 2: peak VO 2 ≤ 14 mL/ kg/min). LA function indices were defined as follows: LA end-systolic diameter (LASd), end-diastolic diameter (LADd), LA systolic volume (LASV), LA diastolic volume (LADV), LA ejection volume (LAEV), and LA ejection fraction (LAEF).LASd, LADd, LASV, and LADV were significantly increased in group 2 (P < 0.001, P < 0.001, P < 0.05, P < 0.005). Group 1 had significantly higher LAEF (P < 0.001 ) and LVEF (P < 0.05). Group 2 had significantly shorter exercise duration, and decreased anaerobic threshold levels and minute ventilation volumes (P < 0.001, P < 0.001, P < 0.005 ). There was a positive correlation between peak VO 2 and LVEF (r = 0.46, P = 0.002), and LAEF (r = 0.61, P < 0.001), peak A wave velocity (r = 0.39, P = 0.009), E wave deceleration time (r = 0.56, P < 0.001), and isovolumic relaxation time (IVRT) (r = 0.35, P = 0.04). There was a negative correlation between peak VO 2 and LASd (r = -0.53, P < 0.001) LADd (r = -0.59, P < 0.001), LASVI (r = -0.34, P = 0.027), LADVI (r = -0.37, P = 0.001), and the E/A ratio (r = -0.41, P = 0.006), Decreased LAEF and increased LA sizes were associated with decreased peak VO 2 . The results clearly demonstrate that LA functions at rest are related to exercise performance in patients with heart failure. (Int Heart J 2005; 46: 123-131)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<b>Value of Left Atrial Function in Predicting Exercise Capacity in Heart Failure With Moderate to Severe Left Ventricular Systolic Dysfunction</b>

et al. 2005

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“…Based on Laplace Law (pressure x radius/2 wall thickness), this threshold may reflect individual optimal wall stretch for clinical stabilization. The left atrium (LA) acts as a reservoir during LV overload (36), and elevated LV filling pressure results in LA overload as well as LV diastolic dysfunction (37). Thus, LA dimension reflects intra-ventricular pressure, in part.…”

Section: Individual Target Threshold Of Bnpmentioning

confidence: 99%

Biomarker for Cardiomyopathy-B-Type Natriuretic Peptide

Nishii¹,

Izumi²

2012

Cardiomyopathies - From Basic Research to Clinical Management

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Cardiomyopathy means "heart (cardio) muscle (myo) disease (pathy)". Currently, cardiomyopathies are defined as myocardial disorders in which the heart muscle is structurally and/or functionally abnormal in the absence of a coronary artery disease, hypertension, valvular heart disease or congenital heart disease sufficient to cause the observed myocardial abnormalities. This book provides a comprehensive, state-of-theart review of the current knowledge of cardiomyopathies. Instead of following the classic interdisciplinary division, the entire cardiovascular system is presented as a functional unity, and the contributors explore pathophysiological mechanisms from different perspectives, including genetics, molecular biology, electrophysiology, invasive and non-invasive cardiology, imaging methods and surgery. In order to provide a balanced medical view, this book was edited by a clinical cardiologist.

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“…Many invasive (16)(17)(18) and noninvasive (19)(20)(21)(22) methods have been suggested for evaluating the contractile function of the left atrium. While the invasive methods are based on a pressurevolume relationship that is taken simultaneously (16,17), noninvasive methods are generated from either the left atrial volumes (LAVs) (10,23) or mitral flow Doppler data (15,19,24).…”

Section: Introductionmentioning

confidence: 99%

“…While the invasive methods are based on a pressurevolume relationship that is taken simultaneously (16,17), noninvasive methods are generated from either the left atrial volumes (LAVs) (10,23) or mitral flow Doppler data (15,19,24). The left atrial dP/dt, one of the invasive methods, was obtained from the left atrial pressure trace by copying that of the left ventricle (18,19).…”

Section: Introductionmentioning

confidence: 99%

The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over time

Eren¹,

Öz²

2010

Anadolu Kardiyol Derg

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The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over timeAkut atriyal fibrilasyonda sinüs ritmi elde edildikten sonra mitral geç diyastolik akım akselerasyon eğimi: Atriyal fonksiyonla ilişkisi ve zamanla değişimi Original Investigation Özgün Araşt›rma 488 ABSTRACTObjective: This study was prospectively designed to evaluate the relationship between the mitral A wave acceleration slope (AWA-slope) and the left atrial ejection fraction (LA-EF) after the restoration of sinus rhythm in patients with atrial fibrillation (AF), and also to evaluate the change in the AWA-slope between the sequent second day and first month. Methods: Twenty-nine patients (16 female, mean age 56±13 years) with unknown cause of AF (except for age) converted to sinus rhythm within the first 48 hours were included into the study. A transthoracic echocardiography was performed in all patients on the second day and the first month after restoration of the sinus rhythm. The paired Student's t test was used in comparisons of the continuous variables. The simple and multiple correlations of the LA-EF were evaluated by the simple and multiple linear regression analyses, respectively. Results: Left atrial ejection fraction (42±17 vs 51±19%, p=0.03) and AWA-slope (950±337 vs 1087±351 cm/sec 2 , p=0.021) obtained after the first month were greater than on the second day. A significant correlation between LA-EF and AWA-slope was observed both on the second day (r=0.76, p<0.001) and at the end of the first month (r=0.71, p<0.001). In addition, there were the correlations between LA-EF and mitral A wave peak velocity (r=0.42, p=0.025) or mitral E/A ratio (r=-0.39, p=0.040) at the end of the first month. On multiple linear regression analysis, only AWA-slope was found to be related to LA-EF (y=9.35+0.04 (AWA-slope), the overall R 2 =0.51, beta =0.71; 95% CI 0.02-0.05; p<0.001). Conclusion: Mitral A wave acceleration slope is a simple, reliable and non-invasive method that can be used to evaluate left atrial contractile function. It can also be used in monitoring of atrial stunning period in patients with sinus rhythm converted from AF.(Anadolu Kardiyol Derg 2010 December 1; 10(6): 488-94)

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In vivo assessment of left atrial contractile performance in normal and pathological conditions using a time-varying elastance model.

Cited by 117 publications

References 35 publications

<b>Value of Left Atrial Function in Predicting Exercise Capacity in Heart Failure With Moderate to Severe Left Ventricular Systolic Dysfunction</b>

<b>Value of Left Atrial Function in Predicting Exercise Capacity in Heart Failure With Moderate to Severe Left Ventricular Systolic Dysfunction</b>

Biomarker for Cardiomyopathy-B-Type Natriuretic Peptide

The mitral late diastolic flow acceleration slope after the restoration of sinus rhythm in acute atrial fibrillation: relationship to atrial function and change over time

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