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Left atrial function assessed by real-time 3-dimensional echocardiography is related to right ventricular systolic pressure in chronic mitral regurgitation.

Abstract：

BACKGROUND:Left atrial (LA) volume is a prognostic index in chronic mitral regurgitation (MR). However, little is known about LA function in this setting. We hypothesized that LA dysfunction is related to pulmonary hypertension in chronic MR. METHODS:Seventy-one patients with organic chronic MR who underwent real-time 3-dimensional transthoracic echocardiography (RT3DE) were studied. Left atrial volumes and peak passive and active LA emptying rates were obtained. Total LA emptying fraction was calculated as follows: [(maximum - minimum LA volume)/maximum LA volume] x 100. Similarly, active and passive LA emptying fractions were calculated. From transmitral flow, the peak early (E) and late (A) diastolic filling velocities and E/A ratio were obtained. The early (E') and late (A') diastolic myocardial velocities were obtained by tissue Doppler interrogation of mitral annulus. RESULTS:Effective regurgitant orifice area (EROA) was 0.57 +/- 0.29 cm(2). Right ventricular systolic pressure (RVSP) was measured in 57 patients and averaged 37 +/- 13 mm Hg. Patients with MR and high RVSP displayed higher minimum LA volume, E/A ratio, E/E' ratio, EROA, and MR volume, and lower A' velocity, peak active LA emptying rate, active LA emptying fraction, and total LA emptying fraction than patients with MR and normal RVSP. Multiple regression analysis revealed that EROA (r = 0.51, P = .01) active LA emptying fraction (r = -0.53, P = .02), E/E' ratio (r = 0.50; P = .04), and the lateral A' velocity (r = -0.46; P = .003) were independently correlated with RVSP. CONCLUSIONS:Left atrial function determined by RT3DE had significant correlation with RVSP in chronic MR, irrespective of MR severity. Thus, pulmonary hypertension in chronic MR may depend not only on MR severity but also on LA function.

journal_name

Am Heart J

journal_title

American heart journal

authors

Saraiva RM,Yamano T,Matsumura Y,Takasaki K,Toyono M,Agler DA,Greenberg N,Thomas JD,Shiota T

doi

10.1016/j.ahj.2009.05.030

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

309-16

issue

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(09)00440-2

journal_volume

158

pub_type

杂志文章

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Left atrial function assessed by real-time 3-dimensional echocardiography is related to right ventricular systolic pressure in chronic mitral regurgitation.