Left atrial geometry and pump function in ischemic cardiomyopathy

Abstract

BackgroundMany of the factors that are known to alter left atrial (LA) contractility are present in patients with ischemic cardiomyopathy (ICM). Nevertheless, preservation of LA contractile function in this group of patients was reported in previous studies. The aim of this study was to assess the changes in LA size, geometry and contractile function in ICM.Methods and results60 subjects (age: 49 ± 12 years, 53% males) in sinus rhythm undergoing coronary angiography (CA), were enrolled in this study; 15 subjects as a control group, 30 patients with reduced ejection fraction (EF) and significant coronary artery disease; as the ICM group, and 15 with reduced EF and normal CA; as the dilated cardiomyopathy (DCM) group.LA dimensions, volume, active emptying fraction (ACTEF) and eccentricity index (LAEi) as well as late diastolic velocities of the mitral annulus (a′) and LA free wall (A3) were measured.Compared with the control group, ICM patients had larger LA volume and reduced ACTEF, a′ and A3, with no significant difference between patients with ICM and DCM in any of these parameters. LA eccentricity was, non-significantly, higher in both cardiomyopathy groups than in the control group.ConclusionsPatients with ICM have increased LA volume and reduced LA contractile function in comparison with normal controls. LA enlargement, LA contractile dysfunction and LA geometric changes in ICM are similar to that occurring in DCM. LA size, contractile function and eccentricity may not be reliable in differentiating ischemic from idiopathic dilated cardiomyopathy.

Determinants of the Volumetric Markers of Left Atrial Contraction Function in Coronary Artery Disease: A Cross-sectional Study

“… 3) 26) Previous research has shown diminished LA active emptying fraction in patients with ischemic cardiomyopathy by comparison with normal subjects. 27) 28) This finding is concordant with our finding regarding diminished LV ejection fraction as an independent determinant of LA contraction function.…”

The prognostic value of the left atrial strain rate determined using cardiovascular magnetic resonance feature tracking imaging in patients with severe idiopathic dilated cardiomyopathy

“…DCM is often associated with left atrial enlargement and impairment of left atrium (LA) reservoir function, conduit function, and pump function ( 4 , 5 ). The previous article reported that left atrial volume index was a prognostic factor for dilated cardiomyopathy ( 6 ).…”

Evaluation of LA Dynamics: a Classical Yet Still Challenging Topic until Now

“…Many studies have analyzed the precise functions of LA with regard to numerous diseases, and there are several studies in the field of LA contractions. 2) 3) 4) 5) LA size and function can be assessed by echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging. In clinical practice, echocardiography is the most common assessment tool because of its simplicity, safety, and ability to image in real time with high temporal resolution.…”