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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Left atrial structure and function and clinical outcomes in the general population.Eur Heart J. 2013; 34: 278-285
- Left atrial function in diastolic heart failure.Circ Cardiovasc Imaging. 2009; 2: 10-15
- Importance of left atrial function in patients with myocardial infarction.Circulation. 1983; 67: 566-571
- Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden.Am J Cardiol. 2002; 90: 1284-1289
- Diastolic dysfunction and left atrial volume: a population-based study.J Am Coll Cardiol. 2005; 45: 87-92
- Left atrial volume: a powerful predictor of survival after acute myocardial infarction.Circulation. 2003; 107: 2207-2212
- Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.J Am Soc Echocardiogr. 2015; 28: 1-39
- Real-time 3D echocardiographic quantification of left atrial volume: multicenter study for validation with CMR.JACC Cardiovasc Imaging. 2012; 5: 769-777
- Left atrial volumes and function by three-dimensional echocardiography: reference values, accuracy, reproducibility, and comparison with two-dimensional echocardiographic measurements.Circ Cardiovasc Imaging. 2016; 9: e004229
- Left ventricular assessment using real time three dimensional echocardiography.Heart. 2003; 89: iii29-iii36
- Left atrial function assessed by real-time 3-dimensional echocardiography is related to right ventricular systolic pressure in chronic mitral regurgitation.Am Heart J. 2009; 158: 309-316
- Quantitative assessment of atrial conduit function: a new index of diastolic dysfunction.Clin Res Cardiol. 2016; 105: 17-28
- Left atrial conduit volume is generated by deviation from the constant-volume state of the left heart: a combined MRI-echocardiographic study.Am J Physiol Heart Circ Physiol. 2004; 286: H2416-H2424
- Effects of aging on left atrioventricular coupling and left ventricular filling assessed using cardiac magnetic resonance imaging in healthy subjects.Am J Cardiol. 2007; 100: 122-127
- Increasing degrees of left ventricular filling impairment modulate left atrial function in humans.Am J Cardiol. 1998; 82: 756-761
- Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography.J Am Soc Echocardiogr. 2010; 23: 961-967
- In vivo assessment of left atrial contractile performance in normal and pathological conditions using a time-varying elastance model.Circulation. 1994; 89: 1829-1838
- Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic.JAMA. 2003; 289: 194-202
- Recommendations for the evaluation of left ventricular diastolic function by echocardiography.J Am Soc Echocardiogr. 2009; 22: 107-133
- Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study.Heart. 2001; 85: 272-277
- Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function.Heart. 2012; 98: 813-820
- Correct estimation of conduit function from left atrial volume curve assessment only is unlikely.J Am Soc Echocardiogr. 2010; 23 (author reply 1333–1334): 1333
- Cardiac mechanics in mild hypertensive heart disease: a speckle-strain imaging study.Circ Cardiovasc Imaging. 2009; 2: 382-390
- Differences of myocardial systolic deformation and correlates of diastolic function in competitive rowers and young hypertensives: a speckle-tracking echocardiography study.J Am Soc Echocardiogr. 2010; 23: 1190-1198
- Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.J Am Soc Echocardiogr. 2016; 29: 277-314
- Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function.Circulation. 1999; 100: 427-436
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.
