Influence of acutely altered loading conditions on left atrial appendage flow velocities

Hoit, Brian D.; Shao, Yanfu; Gabel, Marjorie

doi:10.1016/0735-1097(94)90878-8

Cited by 111 publications

(56 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because the LA appendage compliance is higher than LA main chamber compliance, the LA appendage contributes to LA reservoir function [66][67][68]. When LA pressure increases below a certain level, the LA appendage volume gradually increases, and the peak atrial systolic velocity of LA appendage flow is increased.…”

Section: La Appendage Functionmentioning

confidence: 99%

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

et al. 2005

View full text Add to dashboard Cite

The use of a Swan-Ganz catheter has resulted in the accurate evaluation of the severity of acute left heart failure, making it possible to establish appropriate therapeutic strategies for this disorder using Forrester s classification. The routine use of clinical echocardiography has facilitated the noninvasive diagnosis of hemodynamic abnormalities related to various disease conditions. In particular, transmitral flow (TMF) and pulmonary venous flow (PVF) velocity patterns, acquired by the pulsed Doppler method, have led to the establishment of a new clinical field, diastology [1].Previously, the left ventricle (LV) was the focus of investigation when evaluating left heart function, and the left atrium (LA) was considered to have a minor supporting role. However, recent studies have focused on the role of the LA, because it has been recognized that a thorough understanding of LA performance is essential to evaluate more accurately left heart diseases [2]. When evaluating LV function clinically, hemodynamic abnormalities in the pulmonary vein-LA-LV relationship should always be considered, and echocardiography may be an indispensable tool for obtaining important information concerning the relationship between the pulmonary veins and LV with the LA playing a central role.In this review, we summarize how to evaluate LA function using echocardiography with the role of LA function in patients with left-side heart failure. Basic UnderstandingLeft atrial function is classified into 3 categories based on hemodynamic characteristics [3-6]: 1) reservoir function for blood returning from the pulmonary veins due to active relaxation and passive expansion of the LA during ventricular systole; 2) conduit function promoting direct blood inflow from the pulmonary veins to the LV during ventricular diastole; and 3) booster pump function that is responsible for active ejection of blood into the LV during atrial systole.The blood inflow from the pulmonary veins to the LA and that from the LA to the LV can be evaluated by pulsed Doppler echocardiography based on the PVF velocity pattern (Figure 1, PVF) and the TMF velocity pattern (Figure 1, TMF). Because LA filling and emptying are involved in the hemodynamic relationship between the pulmonary veins, LA and LV, the LA appendage flow velocity pattern (Figure 1, LAAF), recorded by pulsed Doppler echocardiography, and the mitral annular motion velocity pattern (Figure 1, MAMV), recorded by tissue Doppler imaging, also may be important indices for assessing LA function in addition to the LA size determined by M-mode and 2-and 3-dimensional echocardiography, which assess

show abstract

Section: La Appendage Functionmentioning

confidence: 99%

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Mitral annu lus motion as well as left ventricular relaxation were pro posed to have influence on the diastolic LAA forward flow [15]. However, from a transesophageal echocardiographic study on atrial paced dogs with simultaneous measure ment of the pressure and dimension in the left atrium and left ventricle, Hoit et al [16] emphasized the influence of left ventricular relaxation function on the early LAA emptying flow.…”

Section: Influence O F Ventricular Relaxation and Filling On Laa Flowmentioning

confidence: 99%

Left Atrial Appendage Blood Flow Determined by Transesophageal Echocardiography in Patients with Complete Atrioventricular Block

Lin

Chen

et al. 1996

Cardiology

View full text Add to dashboard Cite

Function of the left atrial appendage (LAA) represented by LAA outflow is an important predictor for thrombus formation in patients with nonrheumatic atrial fibrillation, but the pattern of LAA flow in patients with complete atrioventricular (AV) block has rarely been studied. Twenty-one patients with complete AV block and an implanted WI or WIR pacemaker were studied with transesophageal echocardiography. The LAA outflow velocity obtained during the ventricular diastolic phase was significantly higher than that obtained during the ventricular systolic phase (41.5 ± 6.0vs. 34.9 ± 9.7cm/s; p < 0.001). The LAA inflow velocity obtained during the ventricular diastolic phase was also significantly higher than that obtained during the ventricular systolic phase (29.9 ± 7.8 vs. 26.4 ± 5.3 cm/s; p < 0.01). In addition, the LAA outflow and inflow velocity time integrals during the ventricular diastolic phase were significantly higher than those during the ventricular systolic phase (4.66 ± 0.96 vs. 4.08 ± 1.05 cm, p < 0.01, and 2.81 ± 0.77 vs. 2.56 ± 0.65 cm, p < 0.05, respectively). Thus, due to both diastolic augmentation of the LAA flow related to active atrial contraction and minor early diastolic LAA flow formation, left ventricle diastolic function might have some influence on LAA flow. This may have implications for the pathogenesis of LAA thrombi in left ventricular dysfunction.

show abstract

“…Pop et al [24] also demonstrated that patients with a larger transmitral inflow velocity-time integral had less incidence of left atrial SEC. As the LAA flow velocity is influenced by the loading condition of the left atrium [25], the increased left atrial pressure secondary to the increased left ventricular end-diastolic pressure might also play a role in the attenuation of LAA outflow in the patients with impaired left ventricular function.…”

Section: Effect O F Left Ventricular Function On Laa Outflowmentioning

confidence: 99%

Influence of Left Ventricular Diastole on Left Atrial Appendage Blood Flow in Patients with Nonrheumatic Atrial Fibrillation

Lin

Hsu²,

Hwang³

et al. 1997

Cardiology

View full text Add to dashboard Cite

The function of the left atrial appendage (LAA) reflected by the Doppler flow velocity at the outlet of the left atrial appendage has been reported to be correlated with spontaneous echo contrast and thrombus formation. To evaluate the influence of left ventricular diastole on LAA flow during atrial fibrillation (AF), 81 patients with chronic nonrheumatic AF were studied by transesophageal echocardiography. The peak outflow velocity of LAA during ventricular diastole was higher than that during ventricular systole (0.23 ± 0.14 vs. 0.15 ± 0.13 m/s, p < 0.001). The peak inflow velocity of LAA during ventricular diastole was also higher than that during ventricular systole (0.22 ± 0.15 vs. 0.18 ± 0.11 m/s, p < 0.01). Patients with a good left ventricular ejection fraction have a significantly higher peak LAA outflow velocity and a larger diastolic augmentation of LAA outflow (defined by the difference of LAA outflow between systolic and diastolic phases) than patients with an impaired left ventricular function. Thus, left ventricular diastole might have an influence on LAA flow during AF. In addition, the left ventricular function might be considered a predictor of subsequent thromboembolism from the viewpoint of its effect on LAA flow in patients with nonrheumatic AF.

show abstract

Influence of acutely altered loading conditions on left atrial appendage flow velocities

Cited by 111 publications

References 13 publications

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

Renewed Interest in Left Atrial Function: What do we Need to Evaluate Clinically?

Left Atrial Appendage Blood Flow Determined by Transesophageal Echocardiography in Patients with Complete Atrioventricular Block

Influence of Left Ventricular Diastole on Left Atrial Appendage Blood Flow in Patients with Nonrheumatic Atrial Fibrillation

Contact Info

Product

Resources

About