Simultaneous left atrial (LA) and left ventricular (LV) 3-dimensional (3D) echocardiographic
volume measurements enable the quantifying of precise LA function, by virtue of their
independence on any geometric assumption and capability of measurement for net LA
conduit volume. We sought to elucidate the impact of conventional Doppler LV diastolic
property on LA volume and function derived from this method. Our study subjects consisted
of 381 patients who underwent 3D echocardiography. From LA time-volume curve, maximum
and minimum volume index (VI) and VI before atrial contraction (LAVIpre-c) were determined;
subsequently, active emptying volume was calculated as LAVIpre-c − minimum LAVI. From
LA and LV volume measurement, conduit volume was calculated as LV stroke VI − (maximum
LAVI − minimum LAVI). LA volume increased depending on the severity of diastolic dysfunction.
Compared with patients with normal diastolic function, LA booster pump function, as
the contribution of active emptying volume to LV filling, was higher in those with
mild diastolic dysfunction. Additionally, it gradually decreased as diastolic dysfunction
was advanced from mild to moderate and moderate to severe degree (23.2 ± 15.5%, 29.5
± 15.1%, 25.1 ± 16.2%, 14.9 ± 14.1%, respectively; p <0.001). Contrarily, conduit
contribution was significantly higher in patients with severe diastolic dysfunction
than in those with mild diastolic dysfunction; furthermore, conduit function tended
to increase, reciprocally to booster pump function, as diastolic dysfunction grade
was advanced (39.1 ± 28.8%, 36.8 ± 26.2%, 42.7 ± 25.6%, 52.9 ± 26.2%, respectively;
p = 0.034). In conclusion, simultaneous LA and LV volumetric analyses through 3D echocardiography
clearly demonstrate the characteristic LA functional alterations following LA dilation
caused by LV diastolic dysfunction.
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Article Info
Publication History
Published online: February 28, 2017
Accepted:
February 6,
2017
Received in revised form:
February 6,
2017
Received:
November 19,
2016
Footnotes
See page 1692 for disclosure information.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.