Left Atrial Volume

Møller, Jacob Eifer; Hillis, Graham S.; Oh, Jae K.; Seward, James B.; Reeder, Guy S.; Wright, R. Scott; Park, Seung W.; Bailey, Kent R.; Pellikka, Patricia A.

doi:10.1161/01.cir.0000066318.21784.43

Cited by 611 publications

(109 citation statements)

References 24 publications

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“…11 Furthermore, increased LA size has been shown to be associated with a poor outcome 12 in AS patients undergoing aortic valve replacement, 13 and in various other cardiovascular disorders. [14][15][16][17][18][19][20] Our study demonstrates a close association between LA dilatation and increased PCWP and mPAP at rest and during exercise in patients with AS. We found that in patients with pronounced diastolic dysfunction, PCWP>30 mm Hg at peak exercise were characterized by a very high likelihood of LA dilatation (89%).…”

Section: Discussionsupporting

confidence: 59%

Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis

Christensen

Dahl

Carter-Storch

et al. 2016

Circ: Cardiovascular Imaging

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Background— Transition from an asymptomatic to symptomatic state in severe aortic stenosis is often difficult to assess. Identification of a morphological sign of increased hemodynamic load may be important in asymptomatic aortic stenosis to identify patients at risk. Methods and Results— Thirty-nine patients with asymptomatic severe aortic stenosis (aortic valve area <1 cm 2 , peak jet velocity >3.5 m/s) underwent exercise testing with simultaneous invasive hemodynamic monitoring and Doppler echocardiography. Cardiac index, pulmonary artery pressure, and pulmonary capillary wedge pressure (PCWP) were recorded. Patients were followed up for the composite end point of death, unplanned hospitalization, or aortic valve replacement. Patients were stratified into 2 groups according to left atrial (LA) volume index ≥35 mL/m 2 . In 25 patients (64%) LA volume index was ≥35 mL/m 2 . Aortic valve area was similar between groups (0.81±0.15 versus 0.84±0.18 cm 2 ; P =0.58). PCWP was higher at rest and during exercise in patients with LA volume index ≥35 mL/m 2 ( P <0.01), despite similar cardiac index. At rest, PCWP was <12 mm Hg in 11 patients (44%) with LA dilatation, whereas PCWP was <25 mm Hg in 1 patient (4%) with exercise. LA volume index and E/e′ predicted exercise PCWP>30 mm Hg with areas under the receiver operating curve of 0.75 and 0.84, respectively. During follow-up, 14 cardiac events were recorded. LA volume was associated with a hazard ratio of 1.90 (95% confidence interval, 0.92–4.15). Conclusions— LA size reflects hemodynamic burden in patients with asymptomatic severe aortic stenosis. Quantitative measurements of LA and diastolic function are associated with left ventricular filling pressures with exercise and could be used to identify asymptomatic patients with increased hemodynamic burden. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT02395107.

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Section: Discussionsupporting

confidence: 59%

Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis

Christensen

Dahl

Carter-Storch

et al. 2016

Circ: Cardiovascular Imaging

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“…18,20 The presence of LA enlargement is an adverse prognostic marker and is associated with increased risk of atrial fibrillation, HF hospitalizations, stroke, and overall cardiovascular mortality. 18,20,[74][75][76][77] Echocardiography is the most commonly used modality for LA volume estimation, and the biplane area-length method is the recommended method for this purpose. 11 Although 3D echocardiography has been demonstrated to be more accurate and more reproducible, [78][79][80] the lack of a standardized methodology limits its routine use.…”

Section: La Dilatation and Dysfunctionmentioning

confidence: 99%

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Omar

Bansal

Sengupta

2016

Circulation Research

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Echocardiography, given its safety, easy availability, and the ability to permit a comprehensive assessment of cardiac structure and function, is an indispensable tool in the evaluation and management of patients with heart failure (HF). From initial phenotyping and risk stratification to providing vital data for guiding therapeutic decision-making and monitoring, echocardiography plays a pivotal role in the care of HF patients. The recent advent of multiparametric approaches for myocardial deformation imaging has provided valuable insights in the pathogenesis of HF, elucidating distinct patterns of myocardial dysfunction and events that are associated with progression from subclinical stage to overt HF. At the same time, miniaturization of echocardiography has further expanded clinical application of echocardiography, with the use of pocket cardiac ultrasound as an adjunct to physical examination demonstrated to improve diagnostic accuracy and risk stratification. Furthermore, ongoing advances in the field of big data analytics promise to create an exciting opportunity to operationalize precision medicine as the new approach to healthcare delivery that aims to individualize patient care by integrating data extracted from clinical, laboratory, echocardiographic, and genetic assessments. evidence supporting the diagnosis of HF. Echocardiography is the most commonly used modality for this purpose because of its ease of application, noninvasive nature, safety, and ability to provide a vast amount of information about cardiac structure and function. Additionally, echocardiography also plays an important role in guiding therapeutic decision-making and in monitoring response to therapy. Over the past 3 decades, numerous advancements have occurred in the field of echocardiography that have helped improve our understanding of the morpho-functional aberrations occurring in HF. This review summarizes the recent advances in echocardiography as applicable to the evaluation and management of HF. Classification of Heart FailureTo facilitate clinical management, several attempts have been made to divide HF patients into categories that unify them according to their dominant clinical presentations. Thus, HF has often been described as low output failure or high output failure; forward failure or backward failure; systolic HF or diastolic HF; HFrEF or HF with preserved ejection fraction (HFpEF); and so on. More recently, HF has also been classified according to alterations in the mechanical function of the left ventricle (LV; Table 1). 6The classification of HF into systolic or diastolic HF appeared to be intuitive, categorizing patients based on the primary pathogenic abnormality, that is, impairment of cardiac contractility or impairment of filling. However, this description has now been abandoned with the recognition that these 2 entities are not mutually exclusive and have considerable overlap. Significant LV diastolic dysfunction is a ubiquitous occurrence in patients with systolic HF, whereas systolic dysfunction...

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“…В противоположность этому объём левого предсердия (ЛП) менее зависим от острых гемодинамических изменений и отражает подострую или хроническую диастолическую дис-функцию. Прогностическое значение размера и объ-ёма ЛП после ИМ изучалось в нескольких исследова-ниях [28][29][30].…”

Section: прогностическая значимость эхокардиографии после острого инфunclassified

“…Moller JE, et al [29] оценивали объём ЛП, индек-сированный к площади поверхности тела (индекси-рованный объём ЛП) при госпитализации 314 паци-ентов в связи с ОИМ. В течение периода наблюде-ния, составившего в среднем 15 месяцев, 46 па-циентов (15%) умерли.…”

Section: прогностическая значимость эхокардиографии после острого инфunclassified

Predictive Value of Echocardiography in Post Myocardial Infarction Setting. Part 2

Крикунов¹,

Vasyuk²,

Крикунова³

2018

Russ J Cardiol

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Left Atrial Volume

Cited by 611 publications

References 24 publications

Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis

Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Predictive Value of Echocardiography in Post Myocardial Infarction Setting. Part 2

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