Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Badano, Luigi P.; Miglioranza, Marcelo Haertel; Mihaila, S.; Peluso, Diletta; Xhaxho, Jola; Marra, Martina Perazzolo; Cucchini, Umberto; Soriani, Nicola; Iliceto, Sabino; Muraru, Denisa

doi:10.1161/circimaging.115.004229

Cited by 154 publications

(65 citation statements)

References 29 publications

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“…Recently, Authors have provided reference values for LA volumes and function by 3D echocardiography from a group of healthy subjects with a wide age range. 13 CMR is recognised as the gold standard technique to measure ventricular volumes and function; however, its specificity is extended also to left atrium through the use of the short-axis approach that is more reproducible than the biplane area-length method. 14 The strength of CMR is its high spatial resolution and definite myocardial border identification throughout the cardiac cycle.…”

Section: Multimodality Approach In La Assessmentmentioning

confidence: 99%

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

et al. 2017

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SummaryAim: Functional analysis and measurement of left atrium are an integral part of cardiac evaluation, and they represent a key element during non-invasive analysis of diastolic function in patients with hypertension (HT) and/or heart failure with preserved ejection fraction (HFpEF). However, diastolic dysfunction remains quite elusive regarding classification, and atrial size and function are two key factors for left ventricular (LV) filling evaluation. Chronic left atrial (LA) remodelling is the final step of chronic intracavitary pressure overload, and it accompanies increased neurohormonal, proarrhythmic and prothrombotic activities. In this systematic review, we aim to purpose a multi-modality approach for LA geometry and function analysis, which integrates diastolic flow with LA characteristics and remodelling through application of both traditional and new diagnostic tools. Methods:The most important studies published in the literature on LA size, function and diastolic dysfunction in patients with HFpEF, HT and/or atrial fibrillation (AF) are considered and discussed. Results:In HFpEF and HT, pulsed and tissue Doppler assessments are useful tools to estimate LV filling pressure, atrio-ventricular coupling and LV relaxation but they need to be enriched with LA evaluation in terms of morphology and function. An integrated evaluation should be also applied to patients with a high arrhythmic risk, in whom eccentric LA remodelling and higher LA stiffness are associated with a greater AF risk. Conclusion:Evaluation of LA size, volume, function and structure are mandatory in the management of patients with HT, HFpEF and AF. A multi-modality approach could provide additional information, identifying subjects with more severe LA remodelling.Left atrium assessment deserves an accurate study inside the cardiac imaging approach and optimised measurement with established cut-offs need to be better recognised through multicenter studies.

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Section: Multimodality Approach In La Assessmentmentioning

confidence: 99%

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

et al. 2017

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“…The main findings of this study are summarized as follows: (a) We established the reference values of LVLAVR at ventricular end-diastole and at ventricular end-systole; (b) significant age dependency of LVLAVR was observed in both sexes, showing that highest and lowest values were observed in the 3rd and ≥7th decades, respectively; (c) there was also gender dependency, reflecting lower values of LVLAVR at both ventricular end-diastole and ventricular end-systole in female subjects than in male subjects; (d) the contribution of echocardiography parameters was different for LVLAVR at ventricular end-diastole and LVLAVR at ventricular endsystole, characterizing that LV mass and LA functional parameters were correlated with LVLAVR at ventricular enddiastole, and LV mass and LV functional parameters were associated with LVLAVR at ventricular end-systole. 3DE provides accurate and reliable cardiac chamber volumes and their function in clinical practice (Badano et al, 2016;Muraru et al, 2013;Wu et al, 2013). It is generally accepted that aging significantly affects both LV and LA function (Fukuda et al, 2012;Kaku et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Age-and gender-related change in left ventricular (LV) and left atrial (LA) volumes has been reported in healthy subjects (Badano et al, 2016;Kaku et al, 2011). The left ventricle and left atrium are contiguous left heart chambers, and become a conduit during diastole.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have determined the reference values of LV volumes and LV ejection fraction (LVEF) (Aune, Baekkevar, Rodevand, & Otterstad, 2010;Bernard et al, 2017;Chahal et al, 2012;Fukuda et al, 2012;Kaku et al, 2011;Muraru et al, 2013). Although some studies have addressed normal values of 3DE determined LA volumes, majority of current 3DE quantification software was not aimed for LA volume analysis, or it required extensive and tedious manual tracing on LA endocardial border at several time points of the cardiac cycle (Aune, Baekkevar, Roislien, Rodevand, & Otterstad, 2009;Badano et al, 2016;Russo et al, 2017;Wu et al, 2013). Recently, a novel semiautomatic 3DE software, which has capability of both LV and LA volume measurements throughout one cardiac cycle, has been developed.…”

Section: Introductionmentioning

confidence: 99%

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Left ventricular and left atrial volume ratio assessed by three‐dimensional echocardiography: Novel indices for evaluating age‐related change in left heart chamber size

et al. 2019

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We hypothesized that left ventricular and left atrial volume ratio (LVLAVR) assessed by three‐dimensional echocardiography (3DE) reflects age‐ and gender‐related change in left chamber size. We aimed to (1) determine the reference values of LVLAVR, (2) investigate their age and gender dependency, and (3) clarify which anthropometric and echocardiography parameters are closely associated with these indices. Both left ventricular (LV) and left atrial (LA) volume curves were obtained using 3DE speckle tracking analytical software, and the LVLAVR curve throughout one cardiac cycle was created, from which LVLAVR at ventricular end‐diastole and at ventricular end‐systole were determined in 313 healthy subjects (age, 20–85 years; 51% men). The mean values of LVLAVR at ventricular end‐diastole and ventricular end‐systole in male subjects were 5.74 ± 1.54 and 1.37 ± 0.35, respectively. Corresponding values in female subjects were significantly lower (5.20 ± 1.47, p = .003 and 1.13 ± 0.29, p < .001) than the values in male subjects. LVLAVR at ventricular end‐diastole step wisely decreased to advanced aging, and had a highest F ratio compared with other left chamber volumetric parameters in both genders. LV mass and LA ejection fraction were significantly associated with LVLAVR at ventricular end‐diastole. In contrast, LV mass and LV ejection fraction were significantly coupled with LVLAVR at ventricular end‐systole. This study provides the reference values for LVLAVR from a relatively large number of healthy subjects. LVLAVR may be a sensitive parameter to reflect age‐ and gender‐related change in LV and LA volumes. Further studies should be required to determine its clinical usefulness over traditional echocardiography parameters in various cardiovascular diseases.

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“…Cutoff values for LA total, passive and active EF, as well as LA longitudinal strain, were used from previously published studies. 22,23 The association between daytime, nighttime, and day-nighttime hypertension and different LA parameters was determined by univariate logistic regression analysis (odds ratio [OR] and 95% CI). The multivariate logistic regression analysis included different phenotypes of hypertension (daytime, nighttime, and day-nighttime hypertension), age, sex, BMI, 24-hour SBP, E/e', and LVMI.…”

Section: Discussionmentioning

confidence: 99%

The relationship between nighttime hypertension and left atrial function

Tadić

Cuspidi

Pencic-Popovic

et al. 2017

J of Clinical Hypertension

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The authors sought to investigate the association between different hypertensive phenotypes and left atrial (LA) function assessed by the volumetric method and the strain method in patients with untreated hypertension. This cross-sectional study involved 236 untreated patients who underwent 24-hour ambulatory blood pressure monitoring and two-dimensional echocardiographic examination. Our findings showed that LA function gradually deteriorated from patients with normotension, across patients with daytime hypertension, to patients with night-and day-nighttime hypertension. LA reservoir and conduit functions were particularly deteriorated in patients with nighttime and day-nighttime hypertension compared with patients with normotension and patients with daytime hypertension, whereas LA pump function was compensatorily increased only in the participants with day-nighttime hypertension. Only nighttime hypertension and day-nighttime hypertension were independently associated with the reduced reservoir and conduit LA function. The difference between patients with daytime and nighttime hypertension was found in reservoir and conduit LA but not LA pump function. | INTRODUCTIONLeft atrial (LA) enlargement represents a very important and wellknown risk factor for cardiovascular and overall morbidity and mortality.1,2 LA phasic function has long been considered as unimportant.The number of studies that demonstrate the importance of LA reservoir, conduit, and active pump function is increasing. The existing data show that nondipping BP pattern is associated with deterioration of LA function and mechanics, which follows LV remodeling in these patients. 10,11A new classification of hypertensive phenotypes on daytime, nighttime, and day-nighttime hypertension reveals that nighttime hypertension rather than nondipping pattern represents an independent factor associated with LV mass index (LVMI) and LV hypertro- LA remodeling has been reported in patients with hypertension who have asymptomatic diastolic dysfunction. 16,17 Although LA enlargement could be a potential mechanism for compensating the impairment of LV compliance and progression of LV diastolic

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Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Cited by 154 publications

References 29 publications

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

Left ventricular and left atrial volume ratio assessed by three‐dimensional echocardiography: Novel indices for evaluating age‐related change in left heart chamber size

The relationship between nighttime hypertension and left atrial function

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