Relationship of Left Ventricular Size to Left Atrial and Left Atrial Appendage Size in Sinus Rhythm Patients with Dilated Cardiomyopathy

Abstract

Introduction:Thromboembolic events are a frequent cause of mortality in patients with congestive heart failure. The aim of or study was to evaluate the relationship of left ventricular end diastolic diameter (LVEDD) to left atrial (LA) size and left atrial appendage (LAA) size in patients with dilated cardiomyopathy in sinus rhythm, as well as to determine the prevalence of thrombi in LV and LA /LAA.Methods:This was a prospective cross-sectional study, conducted from December 2009 until December 2011. The study included 95 patients with dilated cardiomyopathy in sinus rhythm. Patients with swallowing problems, acute myocardial infarction, atrial fibrillation/flatter, severe systolic dysfunction, and/or patients who were taking oral anticoagulation therapy were excluded.Results:Mean patient age was 58.6 ± 12.2 years and 68.4% were men. Mean LVEDD of our population was 66.5 ± 6.5 mm, while mean LA atrium, LA volume and LAA maximal area were 46 ± 5.1 mm, 87.2 ± 38.7 cm3 and 4.7 ± 1.2 cm2, respectively. LA diameter (p<0.001) and LAA maximal area (p=0.01) showed to be independent predictors of LV size. LV thrombus was detected in 13 (13.7%) patients, while LAA thrombus in 46 (48.4%) patients of our study population.Conclusions:In conclusion, dilated LV size is associated with enlarged LA and LAA size. On the other hand, dilation of LV, LA and LAA is related to high prevalence of left chamber cardiac thrombi.

Echocardiographic study on Dilated Cardiomyopathy from Eastern India

“…In a study from Eastern Europe involving 95 patients, the authors found that left ventricular end diastolic diameter correlated significantly with LA diameter (r=0.47), LA area (r=0.49) as well as volume (r=0.45) 4 . Mean LA diameter of the patients in that study was 46.02±5.07 mm 4 .…”

“…Mean LA diameter of the patients in that study was 46.02±5.07 mm 4 . In present study, the mean LA diameter was 43.95±5.38 mm.…”

“…LAS is found to be related to left ventricular dimensions and increasing LAS is also related with thromboembolic episodes in these patients 4 . In a study from Turkey, the authors also found increased prevalence of atrial fibrillation in DCM patients with increased LA maximal area 5 . However, studies from India concerning echocardiographic findings in DCM are very rare.…”

“…Besides ejection fraction, other echocardiographic measures like left and right ventricular dimensions and left atrial size and volume are also important for prognosis in these patients 3 . Of these different dimensions left atrial size (LAS) is now considered as an important marker of cardiac function 4 . LAS is found to be related to left ventricular dimensions and increasing LAS is also related with thromboembolic episodes in these patients 4 .…”

“…Of these different dimensions left atrial size (LAS) is now considered as an important marker of cardiac function 4 . LAS is found to be related to left ventricular dimensions and increasing LAS is also related with thromboembolic episodes in these patients 4 . In a study from Turkey, the authors also found increased prevalence of atrial fibrillation in DCM patients with increased LA maximal area 5 .…”