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Nemes A, Kormányos Á, Orosz A, Ambrus N, Várkonyi TT, Lengyel C. Autonomic function and specific right atrial functions - Is there a relationship? Correlations from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:600-607. [PMID: 38581157 DOI: 10.1002/jcu.23672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Similarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three-dimensional speckle-tracking echocardiography (3DSTE)-derived right atrial (RA) volumes and strains in healthy subjects. MATERIALS AND METHODS The study comprised 45 healthy adults, but 5 subjects were excluded due to inferior image quality for 3DSTE-derived RA assessments. The remaining 40 individuals being in sinus rhythm had a mean age of 35.1 ± 3.5 years (20 men). Two-dimensional, Doppler, 3DSTE and SCRTs were performed in all cases. RESULTS RA maximum volume and total and passive RA stroke volumes correlated with the Valsalva ratio. Active RA stroke volume and emptying fraction showed correlations with 30/15 ratio. Peak global and mean segmental RA circumferential (CS) and longitudinal strains (LS) showed correlation with the Valsalva ratio. At atrial contraction, global RA-LS and mean segmental RA-CS showed correlations with the Valsalva ratio. Moreover, mean segmental RA-CS correlated with 30/15 ratio and mean segmental RA radial strain showed correlations with systolic blood pressure in response to standing. Autonomic neuropathy score correlated with peak global RA-LS. CONCLUSIONS Autonomic function parameters have significant associations with specific RA functions in healthy adults, making the latter possible indicators of autonomic dysregulation.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Andrea Orosz
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Tamás T Várkonyi
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Nemes A, Kormányos Á, Ambrus N, Lengyel C. Global left ventricular strains and left atrial volumes are not associated in healthy adults - Detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study. IJC HEART & VASCULATURE 2024; 52:101411. [PMID: 38779327 PMCID: PMC11109869 DOI: 10.1016/j.ijcha.2024.101411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
Introduction During the heart cycle, left ventricular (LV) contractility is characterized by complex deformation and rotational mechanics, resulting in LV ejection. The present study seeks to expand our knowledge by examining dependence of LV strains representing LV deformation on left atrial (LA) volumes in healthy circumstances. Therefore, the aim of this study was to evaluate the associations between LA volumes and LV strains as assessed simultaneously by three-dimensional speckle-tracking echocardiography (3DSTE) in normal healthy adults. Methods The present study consisted of 302 healthy adults, but according to exclusion criteria, 137 subjects were excluded due to inferior image quality. The final population comprised 165 individuals (mean age: 33.1 ± 12.3 years, 75 males) who were voluntarily recruited for screening. Two-dimensional echocardiography extended with 3DSTE was performed in all subjects for detailed LV/LA analysis. Results Overall feasibility for simultaneous assessment of LV strains and LA volumes proved to be 55 % with excellent intra- and interobserver correlations. All global LV strains were similar, regardless of the LA volumes examined. All LA volumes and volume-based functional properties respecting the cardiac cycle were similar, regardless the global LV strains examined. Conclusions LV strains and LA volumes can be simultaneously assessed by 3DSTE. Global LV strains and LA volumes are not associated in healthy adults.
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Affiliation(s)
- Attila Nemes
- Corresponding author at: Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, P.O. Box 427, Semmelweis street 8, H-6725 Szeged, Hungary.
| | - Árpád Kormányos
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Nemes A, Kormányos Á, Ambrus N, Lengyel C. Similarities and Differences between Three-Dimensional Speckle-Tracking Echocardiography-Derived Left and Right Atrial Volumes and Volume-Based Functional Properties in the Same Healthy Adults-A Detailed Analysis from the MAGYAR-Healthy Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2051. [PMID: 38138154 PMCID: PMC10744728 DOI: 10.3390/medicina59122051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/23/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: It would be important to know what happens to the volume and volume-based functional properties of one atrium if the size of the other atrium is larger or smaller than the average. Therefore, the present study aimed to perform three-dimensional speckle-tracking echocardiography (3DSTE)-derived quantification of left atrial (LA) and right atrial (RA) volumes and volume-based functional properties to examine these associations in healthy adults with mean and lower or higher than mean atrial volumes. Materials and Methods: The present study consisted of 179 healthy volunteers with a mean age of 32.3 ± 12.3 years (92 males). Three-dimensional speckle-tracking echocardiography-derived LA and RA volumes and volume-based functional properties were determined in all cases. Results: When different LA or RA volume groups were evaluated, both LA and RA showed the same pattern of volume changes in all phases of atrial function with higher LA or RA volumes. In case of low and mean LA volumes, RA volumes were higher compared to their LA counterpart. In case of mean and high RA volumes, RA volumes proved to be higher as well. In case of mean LA or RA volumes, differences between LA and RA stroke volumes (SVs) could not be detected, but all atrial emptying fractions (EFs) were lower for RA than for LA. Some differences were detected in counterpart LA/RA total, passive, and active atrial SVs and EFs values in the presence of lower/higher than mean LA/RA volume. Conclusions: In case of mean LA or RA volumes, RA volumes are higher compared to their LA counterpart, LA-SVs and RA-SVs are similar, but atrial EFs are lower for RA than for LA. If lower/higher than mean LA or RA volumes are present, some differences in patterns of changes in counterpart atrial volumes-SVs and EFs-could be detected.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary; (Á.K.); (N.A.); (C.L.)
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Nemes A, Kormányos Á, Ruzsa Z, Achim A, Ambrus N, Lengyel C. Simultaneously Assessed Three-Dimensional Speckle-Tracking Echocardiography-Derived Left Ventricular and Left Atrial Volumes Are Associated in Healthy Adults-Findings from the MAGYAR-Healthy Study. J Clin Med 2023; 12:4153. [PMID: 37373846 DOI: 10.3390/jcm12124153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The left atrium (LA) has a significant role in regulating blood flow from veins to the left ventricle (LV). LV performance is affected by several factors including preload, which is partly, but highly, dependent on LA volumes. The aim of the present study is to perform simultaneous assessment of LA and LV volume changes during the cardiac cycle in healthy circumstances. Therefore, LA and LV volumes and volume-based functional properties were determined in healthy adults, and the associations of these parameters were examined. METHODS The present study consists of 164 healthy adults (age: 33.0 ± 12.3 years, 82 males) being in sinus rhythm. All subjects have undergone complete two-dimensional Doppler echocardiography with three-dimensional speckle-tracking echocardiography (3DSTE). RESULTS Increased end-systolic maximum LA volume was associated with higher LV volumes and reduced LV ejection fraction. Very high early pre-atrial contraction and late diastolic LA volumes were associated with increased LV volumes, reduced LV ejection fraction and increased LV mass. Increased LA volumes were associated with increased LV mass. Higher LV volumes were associated with tendentiously higher LA volumes. Higher LV end-diastolic volume was associated with tendentiously higher all LA stroke volumes (SVs) and total and active LA emptying fractions (EFs). Higher LV end-systolic volume was associated with tendentiously higher all LA SVs but preserved all LA EFs. CONCLUSIONS 3DSTE is capable of simultaneous assessment of LA and LV volumes and volume-based functional properties for (patho)physiologic studies. Moreover, 3DSTE-derived LV and LA volumes and functional properties show strong associations.
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Affiliation(s)
- Attila Nemes
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Árpád Kormányos
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Zoltán Ruzsa
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Alexandru Achim
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Nóra Ambrus
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Csaba Lengyel
- Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
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Nemes A, Kormányos Á, Ruzsa Z, Achim A, Ambrus N, Lengyel C. Dependence of Left Ventricular Rotational Mechanics on Left Atrial Volumes in Non-Smoker Healthy Adults: Analysis Based on the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Healthy Study. J Clin Med 2023; 12:jcm12031235. [PMID: 36769883 PMCID: PMC9917922 DOI: 10.3390/jcm12031235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
Introduction: As has been established, the left ventricle (LV) and the left atrium (LA) form an organic unit of the left heart; however, little is known about the dependence of LV rotational parameters on LA volumes, even in healthy circumstances. Therefore, the present study aimed to assess the associations between basal and apical LV rotations and LA volumes and volume-based functional properties throughout the cardiac cycle in healthy adults by three-dimensional speckle-tracking echocardiography. Methods: The present study comprised 167 healthy adults (age: 33.4 ± 12.6 years, 77 males) with normally directed LV rotational mechanics. All subjects underwent complete two-dimensional Doppler echocardiography with three-dimensional speckle-tracking echocardiography (3DSTE)-derived data acquisition. The 3DSTE-derived LA volumes and LV rotational parameters were determined at a later date. Results: An increasing end-systolic maximum LA volume (Vmax) was associated with increasing pre-atrial-contraction early (VpreA) and minimum end-diastolic (Vmin) LA volumes, and all stroke volumes were increased as well. Systolic basal left ventricular rotation (LVrot) was highest in the case of the highest systolic Vmax and early-diastolic VpreA. Apical LVrot did not show obvious associations with any increasing LA volumes. The highest systolic basal LVrot was associated with significantly increased diastolic VpreA and Vmin. Reduced diastolic LA volumes (VpreA, Vmin) were seen in the case of increased apical LVrot. An increasing basal LVrot was associated with the tendentious lowering of the apical LVrot and the significant elevation of LV twist. Similarly, an increasing apical LVrot was associated with the tendentious lowering of basal LVrot and the significant elevation of LV twist. Conclusions: Strong associations and adaptations between 3DSTE-derived LA volumes throughout the cardiac cycle and LV rotational mechanics were evidenced, even in healthy circumstances.
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Affiliation(s)
- Attila Nemes
- Correspondence: ; Tel.: +36-62-545220; Fax: +36-62-544568
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Tanaka S, Segawa T, Noda T, Tsugita N, Fuseya T, Kawaguchi T, Iwama M, Watanabe S, Minagawa T, Minatoguchi S, Hiroyuki O. Assessment of visit-to-visit variability in systolic blood pressure over 5 years and phasic left atrial function by two-dimensional speckle-tracking echocardiography. Heart Vessels 2021; 36:827-835. [PMID: 33462685 DOI: 10.1007/s00380-020-01751-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
Visit-to-visit variability in systolic blood pressure (VVV-SBP) has been associated with increased cardiac events. Hence, volume analysis by two-dimensional speckle-tracking echocardiography (2-DSTE) allows physicians to easily measure phasic left atrial (LA) function. However, the relationship of VVV-SBP and functional deformation of the left atrium with patients' clinical outcome is unclear. The aim of the study was to investigate the relationship between phasic LA function and VVV-SBP. The subjects were 70 male participants in whom 2-DSTE was performed to measure blood pressure at health check-ups every year for 5 years. The standard deviation of systolic blood pressure (SBP) was calculated to assess VVV-SBP. The average SBP (Ave-SBP) was also assessed. Total emptying function (EF) (reservoir function), passive EF (conduit function), and active EF (booster pump function) of the left atrium were calculated to evaluate phasic LA function by 2-DSTE. The Pearson correlation, simple regression analysis, and multivariate logistic regression analysis were used in data analysis. Participants' mean age was 50 ± 10 years, and 16 participants had hypertension. VVV-SBP correlated with total EF (r = - 0.30, p = 0.014) and active EF (r = - 0.35, p = 0.003). There was no correlation between the standard deviation of SBP and passive EF (r = - 0.10, p = 0.39). Ave-SBP had no significant relationship with total EF (r = - 0.06, p = 0.62), passive EF (r = - 0.08, p = 0.50), or active EF (r = - 0.03, p = 0.78). Active EF was also associated with VVV-SBP in multiple regression analysis. The active EF was significantly decreased in the highest quartile of VVV-SBP. Despite the small sample size of our study, the VVV-SBP showed a relationship with the phasic LA function. Our findings suggest that high VVV-SBP is noted to be associated with cardiovascular risk including a deterioration of LA function in clinical practice.
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Affiliation(s)
- Shinichiro Tanaka
- The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan.
| | - Tomonori Segawa
- The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan
| | | | - Natsumi Tsugita
- The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan
| | - Takahiro Fuseya
- The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan
| | - Tomonori Kawaguchi
- The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan
| | - Makoto Iwama
- Gifu Prefectural General Medical Center, Gifu, Japan
| | | | | | | | - Okura Hiroyuki
- Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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Nemes A, Kormányos Á, Domsik P, Kalapos A, Ambrus N, Lengyel C. Normal reference values of left atrial volumes and volume-based functional properties using three-dimensional speckle-tracking echocardiography in healthy adults (Insights from the MAGYAR-Healthy Study). JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:49-55. [PMID: 32804419 DOI: 10.1002/jcu.22879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/26/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The present study was designed to define normal reference values of three-dimensional speckle-tracking echocardiography (3DSTE)-derived left atrial (LA) volumes, stroke volumes (SVs), and emptying fractions (EFs) with regard to the cardiac cycle. METHODS The present study involved 256 healthy adult subjects in sinus rhythm who underwent complete two-dimensional Doppler echocardiography and 3DSTE at the same time. However, due to inferior image quality, 87 subjects have been excluded. The remaining population sample comprised of 169 patients who gave informed consent to participate in the study. RESULTS While systolic maximum LA volume and early diastolic preatrial contraction LA volume did not change over age decades, late-diastolic minimum LA volume decreased and was lowest in subjects aged 40 to 49 years then increased after 50 years. Total atrial EF increased over age decades with a reduction after 50 years. Passive atrial EF showed a significant continuous increase over age decades. Active atrial EF did not change in younger ages and was the highest between ages 40 and 49 years with a significant impairment after 50 years. CONCLUSIONS This study shows the age- and gender-dependency of normal values of 3DSTE-derived LA volumes, stroke volumes, and emptying fractions with regard to the cardiac cycle in healthy adult subjects.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Nemes A, Kormányos Á, Domsik P, Kalapos A, Ambrus N, Lengyel C. Normal reference values of three-dimensional speckle-tracking echocardiography-derived right atrial volumes and volume-based functional properties in healthy adults (Insights from the MAGYAR-Healthy Study). JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:263-268. [PMID: 31737908 DOI: 10.1002/jcu.22795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/04/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The right atrium (RA) roles include being a systolic reservoir, an early diastolic conduit, and a late-diastolic booster pump. The present study aimed to assess normal reference values of three-dimensional speckle-tracking echocardiography (3DSTE)-derived RA volumetric data and volume-based functional properties in healthy adult subjects. METHODS We included 260 healthy adult subjects in sinus rhythm with complete clinical and demographic dataset, but excluded 110 of them because of inferior image quality. The remaining population sample comprised 150 subjects (31.0 ± 11.6 years, 79 males). Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all subjects. RESULTS Systolic RA volumetric variables did not show changes over time, but after 50 years, a significant reduction could be demonstrated in RA stroke volume and emptying fraction. While early diastolic RA volume increased over time, RA stroke volume and emptying fraction decreased. While late-diastolic RA volume increased over age decades, similar increase could be detected in RA stroke volume but a reduction occurred in older ages. Late-diastolic RA emptying fraction showed an increasing (after the 40s)-decreasing (after the 50s) pattern. CONCLUSIONS Our study provides normal reference values of 3DSTE-derived RA volumes and volume-based functional properties and their age- and gender dependency in healthy adult subjects.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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Sato H, Kawasaki M, Tanaka R, Yoshizane T, Ono K, Tadokoro M, Yano Y, Kondou T, Kariya T, Nagata K, Gotoh K, Sawada S, Noda T, Watanabe S. Relationships among pulmonary capillary wedge pressure, dry weight and natriuretic peptide in patients undergoing hemodialysis: a three-dimensional speckle tracking echocardiography study. J Echocardiogr 2020; 18:160-168. [PMID: 31997088 DOI: 10.1007/s12574-020-00461-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/15/2019] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although the evaluation of fluid status in hemodialysis (HD) patients is useful, relationship among pulmonary capillary wedge pressure (PCWP), dry body weight (DW) and natriuretic peptide has not been elucidated. In addition, there has been no objective marker for instantaneously monitoring hemodynamic improvement in response to HD. We previously reported that PCWP and time constant of left ventricular pressure decline (Tau) can be noninvasively estimated (ePCWP and eTau) by speckle tracking echocardiography (STE). The aim of this study was to elucidate the relationship among ePCWP, eTau, DW and natriuretic peptide in patients undergoing HD. METHODS We measured ePCWP and body weight (BW) by STE in 81 patients and ANP and BNP by blood examination in 31 patients just before and after HD during sinus rhythm. RESULTS The ePCWP decreased after HD, and this was associated with reductions in ln ANP, eTau and BW (r = 0.523, 0.271 and 0.814, respectively, p < 0.05). The % change in ePCWP was not correlated with the % change in ln BNP (p = 0.47). The change in ePCWP had a stronger correlation with the % change in BW than the change in any other parameters. CONCLUSIONS The ePCWP is more sensitive to estimate the change in BW during HD than any other parameters such as ANP and BNP. These results indicated that a substantial amount of excess fluid can be assessed real-time by STE using ePCWP.
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Affiliation(s)
- Hidemaro Sato
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Masanori Kawasaki
- Cardiovascular Medicine, Gifu Heart Center, 4-14-4 Yabuta-minami, Gifu, 500-8384, Japan.
| | - Ryuhei Tanaka
- Department of Cardiology, Asahi University Hospital, Gifu, Japan
| | - Takashi Yoshizane
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Koji Ono
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | | | - Yoko Yano
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Takehito Kondou
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Tatsuya Kariya
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Kijun Nagata
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Koshi Gotoh
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Shigeki Sawada
- Department of Internal Medicine, Sawada Hospital, Gifu, Japan
| | - Toshiyuki Noda
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Sachiro Watanabe
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
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Bytyçi I, Bajraktari G, Lindqvist P, Henein MY. Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis. Clin Physiol Funct Imaging 2019; 39:297-307. [PMID: 31136072 DOI: 10.1111/cpf.12587] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/20/2019] [Indexed: 02/05/2023]
Abstract
AIM This meta-analysis assesses left atrial (LA) cavity and myocardial function measurements that predict pulmonary capillary wedge pressure (PCWP). METHODS PubMed-MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry were searched up to December 2018 for studies on the relationship of LA diameter, LA indexed volume (LAVI max, LAVI min), peak atrial longitudinal (PALS), peak atrial contraction (PACS) strain and total emptying fraction (LAEF) with PCWP. Eighteen studies with 1343 patients were included. Summary sensitivity and specificity (with 95% CI) for evaluation of diagnostic accuracy and the best cut-off values for different LA indices in predicting raised PCWP were estimated using summary receiver operating characteristic analysis. RESULTS The pooled analysis showed association between PCWP and LA diameter: Cohen's d = 0·87, LAVI max: d = 0·92 and LAVI min: d = 1·0 (P<0·001 for all). A stronger correlation was found between PCWP and PALS: d = 1·26, and PACS: d = 1·62, total EF d = 1·22 (P<0·0001 for all). PALS ≤19% had a summary sensitivity of 80% (65-90) and summary specificity of 77% (52-92), positive likelihood ratio (LR+) 3·74, negative likelihood ratio (LR-) <0·25 and DOR > 15·1 whereas LAVI ≥34 ml m-2 had summary sensitivity of 75% (55-89) and summary specificity 77% (57-90), with LR+ >3, LR- 0·32 and DOR >10·1. CONCLUSIONS Compromised LA myocardial function and increased size predict raised cavity pressure. These results should assist in optimum follow-up of patients with fluctuating LA pressure.
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Affiliation(s)
- Ibadete Bytyçi
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Umeå Heart Centre, Umeå, Sweden
- Universi College, Pristina, Kosovo, Albania
- Clinic of Cardiology, University Clinical Centre of Kosovo, Pristina, Kosovo, Albania
| | - Gani Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Umeå Heart Centre, Umeå, Sweden
- Universi College, Pristina, Kosovo, Albania
| | - Per Lindqvist
- Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology, Umeå University, Umeå, Sweden
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Umeå Heart Centre, Umeå, Sweden
- Molecular and Clinic Research Institute, St George University, London, UK
- Brunel University, London, UK
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Tanaka S, Noda T, Kawasaki M, Segawa T, Tsugita N, Fuseya T, Kubota T, Iwama M, Nishigaki K, Watanabe S, Minagawa T, Ohashi H, Minatoguchi S. Relationship between electrical conduction and phasic left atrial function: P-wave signal-averaged electrocardiography and time-left atrial volume curve assessments using two-dimensional speckle-tracking echocardiography. Heart Vessels 2019; 34:1212-1220. [DOI: 10.1007/s00380-019-01351-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
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Vitarelli A, Gaudio C, Mangieri E, Capotosto L, Tanzilli G, Ricci S, Viceconte N, Placanica A, Placanica G, Ashurov R. Bi-Atrial Function before and after Percutaneous Closure of Atrial Septum in Patients with and without Paroxysmal Atrial Fibrillation: A 2-D and 3-D Speckle Tracking Echocardiographic Study. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1198-1211. [PMID: 29609808 DOI: 10.1016/j.ultrasmedbio.2018.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 06/08/2023]
Abstract
Our aim was to analyze atrial function with 2-D (2-D-STE) and 3-D (3-D-STE) speckle tracking echocardiography in patients with atrial septal devices and paroxysmal atrial fibrillation (PAF). One hundred sixteen patients and a subgroup of 22 patients who developed PAF after device insertion were studied. Left atrial and right atrial peak longitudinal strain and standard deviations of time to peak strain (TPS) were calculated using 2-D-STE. The left atrial/right atrial emptying fraction and expansion index were determined using 3-D-STE. By multivariate analysis, pre-closure 3-D right atrial expansion index, left atrial time to peak strain, and 3-D left atrial expansion index were independently associated with PAF. Compared with the other indices, receiver operating characteristic analysis revealed better diagnostic accuracy for the combination of pre-closure time to peak strain and 3-D expansion index in detecting PAF. Patients with atrial septal devices have pre-existing left and right atrial dilation and dysfunction as assessed by 2-D-STE and 3-D-STE that appear sensitive for the stratification of PAF risk in this population.
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Affiliation(s)
- Antonio Vitarelli
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy.
| | - Carlo Gaudio
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Enrico Mangieri
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Lidia Capotosto
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Gaetano Tanzilli
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Serafino Ricci
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Nicola Viceconte
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Attilio Placanica
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Placanica
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Rasul Ashurov
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
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Földeák D, Kormányos Á, Domsik P, Kalapos A, Piros GÁ, Ambrus N, Ajtay Z, Sepp R, Borbényi Z, Forster T, Nemes A. Left atrial dysfunction in light-chain cardiac amyloidosis and hypertrophic cardiomyopathy - A comparative three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study. Rev Port Cardiol 2017; 36:905-913. [PMID: 29233648 DOI: 10.1016/j.repc.2017.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/31/2017] [Accepted: 06/13/2017] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION While cardiac amyloidosis (CA) is a rare systemic disease characterized by extracellular deposition of protein-derived fibrils, hypertrophic cardiomyopathy (HCM) is histopathologically characterized by myocyte hypertrophy and disarray, interstitial fibrosis, and small intramural coronary arteriole dysplasia. The aim of the present study was to compare left atrial (LA) volumetric and functional characteristics between light-chain (AL) CA and HCM by three-dimensional (3D) speckle-tracking echocardiography (STE). METHODS The AL-CA group initially consisted of 17 patients with AL-CA, but one patient was excluded due to inadequate image quality, and so the study population consisted of 16 patients (mean age: 64.0±9.6 years, five men). Their results were compared with data on 20 age-matched HCM patients (mean age: 59.8±5.2 years, 10 men) and on 16 age-matched healthy controls (mean age: 58.2±7.2 years, six men). Complete two-dimensional Doppler echocardiography and 3D-STE were performed in all cases. RESULTS Significantly increased LA volumes were observed in both AL-CA and HCM compared with the control group. Only active atrial emptying fraction was found to be significantly reduced in AL-CA patients compared to controls. Peak global and mean segmental circumferential, longitudinal and area strains showed significant reductions in AL-CA patients compared with controls, but only peak mean segmental longitudinal strain differed significantly between HCM patients and controls. While no differences were demonstrated in global and mean segmental strain at atrial contraction between HCM patients and controls, AL-CA patients showed reductions in certain strain parameters compared to controls and HCM patients. CONCLUSIONS Different patterns of LA functional characteristics were demonstrated in AL-CA and HCM patients by 3D-STE.
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Affiliation(s)
- Dóra Földeák
- Division of Haematology, 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Árpád Kormányos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Györgyike Á Piros
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nóra Ambrus
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zénó Ajtay
- Vilmos Zsigmondy SPA Hospital, Harkány, Hungary; Heart Institute, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Sepp
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Zita Borbényi
- Division of Haematology, 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Attila Nemes
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
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Földeák D, Kormányos Á, Domsik P, Kalapos A, Piros GÁ, Ambrus N, Ajtay Z, Sepp R, Borbényi Z, Forster T, Nemes A. Left atrial dysfunction in light-chain cardiac amyloidosis and hypertrophic cardiomyopathy – A comparative three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Havasi K, Domsik P, Kalapos A, McGhie JS, Roos-Hesselink JW, Forster T, Nemes A. Left Atrial Deformation Analysis in Patients with Corrected Tetralogy of Fallot by 3D Speckle-Tracking Echocardiography (from the MAGYAR-Path Study). Arq Bras Cardiol 2017; 108:129-134. [PMID: 28327874 PMCID: PMC5344657 DOI: 10.5935/abc.20170004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 09/13/2016] [Indexed: 11/20/2022] Open
Abstract
Background Three-dimensional (3D) echocardiography coupled with speckle-tracking echocardiographic (STE) capability is a novel methodology which has been demontrated to be useful for the assessment of left atrial (LA) volumes and functional properties. There is increased scientific interest on myocardial deformation analysis in adult patients with corrected tetralogy of Fallot (cTOF). Objectives To compare LA volumes, volume-based functional properties and strain parameters between cTOF patients and age- and gender-matched healthy controls. Methods The study population consisted of 19 consecutive adult patients with cTOF in sinus rhythm nursing at the University of Szeged, Hungary (mean age: 37.9 ± 11.3 years, 8 men, who had repair at the age of 4.1 ± 2.5 years). They all had undergone standard transthoracic two-dimensional Doppler echocardiographic study extended with 3DSTE. Their results were compared to 23 age- and gender-matched healthy controls (mean age: 39.2 ± 10.6 years, 14 men). Results Increased LA volumes and reduced LA emptying fractions respecting cardiac cycle could be demonstrated in cTOF patients compared to controls. LA stroke volumes featuring all LA functions showed no differences between the 2 groups examined. LA global and mean segmental uni- and multidirectional peak strains featuring LA reservoir function were found to be diminished in adult patients with cTOF as compared to controls. Similarly to peak strains reduced global and mean segmental LA strains at atrial contraction characterizing atrial booster pump function could be demonstrated in cTOF patients as compared to controls. Conclusions Significant deterioration of all LA functions could be demonstrated in adult patients with cTOF late after repair.
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Affiliation(s)
- Kálmán Havasi
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Jackie S McGhie
- Department of Cardiology - Erasmus MC - Rotterdam - The Netherlands
| | | | - Tamás Forster
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
| | - Attila Nemes
- 2nd Department of Medicine and Cardiology Center - Medical Faculty - Albert Szent-Györgyi Clinical Center - University of Szeged - Szeged - Hungary
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16
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Maceira AM, Cosin-Sales J, Prasad SK, Pennell DJ. Characterization of left and right atrial function in healthy volunteers by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2016; 18:64. [PMID: 27719670 PMCID: PMC5056480 DOI: 10.1186/s12968-016-0284-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/15/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Left and right atrial function show a different pattern in advanced age in order to maintain adequate ventricular filling. It has been shown that left atrial (LA) function has a prognostic value in a number of heart conditions. Cardiovascular magnetic resonance (CMR) provides high quality images of the left and right atria using high temporal resolution steady state free precession (SSFP) cine sequences. We used SSFP cines to characterize atrial function in healthy, normotensive, volunteers. METHODS We measured maximum, preatrial contraction and minimum left and right atrial volumes in 120 healthy subjects after careful exclusion of cardiovascular abnormality (60 men, 60 women; 20 subjects per age decile from 20 to 80 years). Data were generated from 3-dimensional modeling, including tracking of the atrioventricular ring motion and time-volume curves analysis. With those measurements, all the usual parameters for left and right atrial function were calculated. RESULTS Gender had significant influence on some parameters of left and right atrial conduit and booster pump function. Age significantly influenced the majority of parameters of both left and right atrial function, with typically lower reservoir and conduit functions and higher booster pump function, both in males and females belonging to older age groups. CMR normal ranges were modelled for clinical use with normalization, where appropriate, for body surface area and gender, displaying parameters with respect to age. CONCLUSIONS CMR normal reference ranges for components of left and right atrial function are provided for males and females for a wide age range.
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Affiliation(s)
- Alicia M. Maceira
- Cardiovascular Imaging Unit, ERESA Medical Center, MR Unit, Hospital Arnau de Vilanova, Valencia, RIC Spain
- Department of Medicine, Health Sciences School, CEU Cardenal Herrera University, Valencia, Spain
| | - Juan Cosin-Sales
- Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain
| | - Sanjay K. Prasad
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
| | - Dudley J. Pennell
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
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17
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Santos ABS, Roca GQ, Claggett B, Sweitzer NK, Shah SJ, Anand IS, Fang JC, Zile MR, Pitt B, Solomon SD, Shah AM. Prognostic Relevance of Left Atrial Dysfunction in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail 2016; 9:e002763. [PMID: 27056882 DOI: 10.1161/circheartfailure.115.002763] [Citation(s) in RCA: 219] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/04/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Left atrial (LA) size is an established marker of risk for adverse outcomes in heart failure with preserved ejection fraction (HFpEF). However, the independent prognostic importance of LA function in HFpEF is not known. METHODS AND RESULTS We assessed LA function measured by speckle-tracking echocardiography in 357 patients with HFpEF enrolled in the Treatment Of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial who were in sinus rhythm at the time of echocardiography. Lower peak LA strain, indicating LA dysfunction, was associated with older age, higher prevalence of atrial fibrillation and left ventricular (LV) hypertrophy, worse LV and right ventricular systolic function, and worse LV diastolic function. At a mean follow-up of 31 months (interquartile range, 18-43months), 91 patients (25.5%) experienced the primary composite end point of cardiovascular death, HF hospitalization, and aborted sudden death. Lower peak LA strain was associated with a higher risk of the composite end point (hazard ratio, 0.96 per unit of reduction in strain; 95% confidence interval, 0.94-0.99; P=0.009) and of HF hospitalization alone (hazard ratio, 0.95 per unit of reduction in strain; 95% confidence interval, 0.92-0.98; P=0.003). The association of LA strain with incident HF hospitalization remained significant after adjustment for clinical confounders, but not after further adjustment for LV global longitudinal strain and the E/E' ratio, parameters of LV systolic and diastolic function, respectively. CONCLUSIONS LA dysfunction in HFpEF is associated with a higher risk of HF hospitalization independent of potential clinical confounders, but not independent of LV strain and filling pressure. Impairment in LV systolic and diastolic function largely explains the association between impaired LA function and higher risk of HF hospitalization in HFpEF. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00094302.
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Affiliation(s)
- Angela B S Santos
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Gabriela Querejeta Roca
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Brian Claggett
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Nancy K Sweitzer
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Sanjiv J Shah
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Inder S Anand
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - James C Fang
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Michael R Zile
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Bertram Pitt
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Scott D Solomon
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.)
| | - Amil M Shah
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.B.S.S., G.Q.R., B.C., S.D.S., A.M.S.); Cardiology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal of Rio Grande do Sul, Porto Alegre, Brazil (A.B.S.S.); Division of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); Cardiology Division, University of Utah School of Medicine, Salt Lake City (J.F.); RHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston (M.R.Z.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor (B.P.).
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18
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Nemes A, Piros GÁ, Lengyel C, Domsik P, Kalapos A, Várkonyi TT, Orosz A, Forster T. Complex evaluation of left atrial dysfunction in patients with type 1 diabetes mellitus by three-dimensional speckle tracking echocardiography: results from the MAGYAR-Path Study. Anatol J Cardiol 2016; 16:587-593. [PMID: 27004713 PMCID: PMC5368514 DOI: 10.5152/anatoljcardiol.2015.6225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Changes in left atrial (LA) function can be observed in type 1 diabetes mellitus (T1DM). Three-dimensional (3-D) speckle tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of LA. The objective of the present study was to compare 3DSTE-derived LA volumetric and strain parameters between T1DM patients and matched healthy controls. METHODS This prospective study consists of 17 subcutaneous insulin pump-treated non-obese patients with T1DM (mean age: 33.5±8.2 years, 8 males). To exclude possible cardiovascular disease, patients with complaints of chest pain, dyspnea, or signs of cerebrovascular disease or peripheral artery disease were not included. Their results were compared with 20 age-matched and gender-matched healthy controls (mean age: 36.9±11.0 years, 9 males). Independent sample Student t-test and Fisher's exact test were used for comparisons. Bland-Altman method was used for evaluating intraobserver and interobserver correlations. RESULTS Anemia and impaired renal function were not confirmed in T1DM patients. Calculated LA maximum and minimum volumes and LA volume before atrial contraction were significantly increased in T1DM patients. Total atrial stroke volume was increased (23.6±6.9 mL vs. 19.6±4.6 mL, p=0.04), whereas mean segmental circumferential peak strain was decreased (28.9%±11.4% vs. 37.3%±12.5%, p=0.04). Segmental basal longitudinal and area strains were increased, whereas segmental superior circumferential and area strains and midatrial 3-D strain were decreased in T1DM. CONCLUSION Both 3DSTE-derived volumetric and strain analysis confirmed alterations in LA function, suggesting early LA remodeling in patients with T1DM.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary.
| | - Györgyike Ágnes Piros
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Csaba Lengyel
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Péter Domsik
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Anita Kalapos
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Tamás T Várkonyi
- 1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Andrea Orosz
- Department of Pharmacology and Pharmacotherapy, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
| | - Tamás Forster
- 2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged-Hungary
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Maekawa Y, Akita K, Tsuruta H, Yamada Y, Hayashida K, Yuasa S, Murata M, Jinzaki M, Fukuda K. Significant reduction of left atrial volume concomitant with clinical improvement after percutaneous transluminal septal myocardial ablation for drug-refractory hypertrophic obstructive cardiomyopathy, and its precise detection with multidetector CT. Open Heart 2016; 3:e000359. [PMID: 27307994 PMCID: PMC4893874 DOI: 10.1136/openhrt-2015-000359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/19/2016] [Accepted: 02/14/2016] [Indexed: 11/30/2022] Open
Abstract
Objective In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. Methods We studied a consecutive cohort of 20 patients with drug-refractory symptomatic HOCM after PTSMA. We evaluated LA volume analyses with cardiac MDCT on patients who underwent PTSMA as compared to echocardiography. Results Before PTSMA, 75% of all patients had heart failure-associated symptoms in the New York Heart Association functional class III/IV. All patients experienced relief from heart failure-associated symptoms after PTSMA. Cardiac MDCT showed significant reduction in the index of maximum LA volume during follow-up compared to before PTSMA in the same way as in echocardiography (93.6±34.1 mL/m2 vs 82.6±35.3 mL/m2, p=0.035). A Bland-Altman plot showed small mean differences and limits of agreement in the measurements of the index of maximum LA volume before and after PTSMA between echocardiography and MDCT. Conclusions The follow-up cardiac MDCT was a useful tool to evaluate the effectiveness of PTSMA on reduction of LA volume. Cardiac MDCT might provide comparable measurements of the LA volume in patients with drug-refractory symptomatic HOCM before and after PTSMA compared to echocardiography.
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Affiliation(s)
- Yuichiro Maekawa
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Keitaro Akita
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Hikaru Tsuruta
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Yoshitake Yamada
- Department of Diagnostic Radiology , Keio University School of Medicine , Tokyo , Japan
| | - Kentaro Hayashida
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Shinsuke Yuasa
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Mitsushige Murata
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology , Keio University School of Medicine , Tokyo , Japan
| | - Keiichi Fukuda
- Department of Cardiology , Keio University School of Medicine , Tokyo , Japan
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Characterization of left atrial dysfunction in hypereosinophilic syndrome – Insights from the Motion analysis of the heart and great vessels by three-dimensional speckle tracking echocardiography in pathological cases (MAGYAR-Path) Study. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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21
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Nemes A, Marton I, Domsik P, Kalapos A, Pósfai É, Modok S, Borbényi Z, Forster T. Characterization of left atrial dysfunction in hypereosinophilic syndrome – Insights from the Motion analysis of the heart and great vessels by three-dimensional speckle tracking echocardiography in pathological cases (MAGYAR-Path) Study. Rev Port Cardiol 2016; 35:277-83. [DOI: 10.1016/j.repc.2015.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 11/22/2015] [Indexed: 11/15/2022] Open
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22
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Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiography (from the MAGYAR-Healthy Study). Rev Port Cardiol 2016; 35:83-91. [DOI: 10.1016/j.repc.2015.09.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/22/2015] [Accepted: 09/02/2015] [Indexed: 11/20/2022] Open
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23
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Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiography (from the MAGYAR-Healthy Study). REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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24
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Impact of gender and healthy aging on pulmonary capillary wedge pressure estimated by the kinetics-tracking index using two-dimensional speckle tracking echocardiography. Hypertens Res 2016; 39:327-33. [PMID: 26791012 DOI: 10.1038/hr.2015.149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 11/08/2022]
Abstract
Risk stratification in heart failure (HF) among patients and healthy subjects using pulmonary capillary wedge pressure (PCWP) is important for understanding when and why HF develops. The aim of the present study was to evaluate the impact of gender and healthy aging on estimated PCWP using a kinetics-tracking index in patients and in healthy subjects without hypertension. The study population consisted of 198 healthy subjects without cardiovascular or other systemic diseases and who were not taking any medications. Echocardiographic studies were performed using an ACUSON Sequoia 512 ultrasound system. Active left atrial (LA) emptying function (EF) was defined as (pre-atrial contraction LA volume-minimum LA volume)/pre-atrial contraction LA volume × 100%. With an increase in age, the E/A and E/e' ratios (markers of left ventricular (LV) diastolic dysfunction (DD)) showed a similar decrease in males and females. PCWP was maintained at 8.3±1.8 mm Hg in males and 8.2±2.3 mm Hg in females because of compensation by an increase in active LA EF. In contrast, the compensation for LV DD with an increase in active LA EF in females tended to be more gradual (slope=0.11) than in males (slope=0.18, P=0.060 vs. female). The parameters that indicated LV DD deteriorated with advancing age. PCWP might be maintained because of compensation, namely an increase in active LA EF in both males and females. The compensation in female septuagenarians and octogenarians was weaker than in male septuagenarians and octogenarians. This difference in compensation may explain why HF with preserved LV ejection fraction occurs more frequently in females than in males.
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The Pivotal Role Of Studying The Left Atrium By Speckle Tracking In Heart Failure. Hellenic J Cardiol 2016; 57:30-2. [DOI: 10.1016/s1109-9666(16)30015-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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26
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Nemes A, Piros GÁ, Domsik PÉ, Kalapos A, Forster T. Left Atrial Volumetric and Strain Analysis by Three-Dimensional Speckle-Tracking Echocardiography in Noncompaction Cardiomyopathy: Results from the MAGYAR-Path Study. Hellenic J Cardiol 2016; 57:23-9. [DOI: 10.1016/s1109-9666(16)30014-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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27
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Left ventricular layer function in hypertension assessed by myocardial strain rate using novel one-beat real-time three-dimensional speckle tracking echocardiography with high volume rates. Hypertens Res 2015; 38:551-9. [DOI: 10.1038/hr.2015.47] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/23/2015] [Accepted: 03/03/2015] [Indexed: 11/08/2022]
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Cong J, Yang X, Zhang N, Shen J, Fan T, Zhang Z. Quantitative analysis of left atrial volume and function during normotensive and preeclamptic pregnancy: a real-time three-dimensional echocardiography study. Int J Cardiovasc Imaging 2015; 31:805-12. [DOI: 10.1007/s10554-015-0628-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/17/2015] [Indexed: 10/24/2022]
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Kawasaki M, Tanaka R, Ono K, Minatoguchi S, Watanabe T, Iwama M, Hirose T, Arai M, Noda T, Watanabe S, Zile MR, Minatoguchi S. A novel ultrasound predictor of pulmonary capillary wedge pressure assessed by the combination of left atrial volume and function: A speckle tracking echocardiography study. J Cardiol 2014; 66:253-62. [PMID: 25547741 DOI: 10.1016/j.jjcc.2014.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 10/21/2014] [Accepted: 11/12/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND We hypothesized that a development of a novel index based on the combination of left atrial volume (LAV) and left atrial (LA) function evaluated by the time-LA volume curve using speckle tracking echocardiography (STE) would be accurate and useful to estimate pulmonary capillary wedge pressure (PCWP). Our goal was to develop a novel index of PCWP based on a combination of LAV and LA function using STE. METHODS A cross-validation study was performed with the patients divided into a training study to define the novel index (n=50) and a testing study to validate the index (n=196). PCWP was measured by right heart catheterization, and phasic LAV and emptying function (EF) were measured by STE. RESULTS Simple linear regression analysis in the training study revealed that the novel index that best estimated PCWP was the kinetics-tracking index [KT index=log10 (active LAEF/minimum LAV index)]. Multiple regression analysis revealed that the KT index was the most reliable predictor of PCWP. It had the strongest correlation with PCWP (r=-0.86, p<0.001) among all echocardiographic parameters. In the testing study, PCWP estimated by the KT index was also strongly correlated with measured PCWP (r=0.92, p<0.001). These correlations were also strong in the patients with reduced left ventricular ejection fraction (<50%), chronic heart failure, and chronic atrial fibrillation (r=0.92, r=0.91, r=0.79, p<0.001, respectively). CONCLUSIONS A novel index (KT index) using a combination of LAV and LA function was a powerful and useful predictor of PCWP and may be valuable in routine clinical practice.
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Affiliation(s)
- Masanori Kawasaki
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Ryuhei Tanaka
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Koji Ono
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Shingo Minatoguchi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takatomo Watanabe
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Makoto Iwama
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Takeshi Hirose
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Masazumi Arai
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Toshiyuki Noda
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Sachiro Watanabe
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Michael R Zile
- Medicine-Cardiology, Medical University of South Carolina and Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA
| | - Shinya Minatoguchi
- Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
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Müller H, Lerch R. Three-dimensional Echocardiographic Analysis of left Atrial size and Volumetric Function — Clinical Implications and Comparison with Other Imaging Modalities. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9299-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nemes A, Forster T. [Assessment of left atrial size and function -- from M-mode to 3D speckle-tracking echocardiography]. Orv Hetil 2014; 155:1624-31. [PMID: 25282107 DOI: 10.1556/oh.2014.30007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Left atrium is not a passive heart chamber, because it has a dynamic motion respecting heart cycle and, in accordance with its stretching, it releases atrial natriuretic peptides. Since in the course of certain invasive procedures the size of left atrium may change substantially, its exact measurement and functional characterization are essential. The aim of the present review is to summarize echocardiographic methods for the assessment of left atrial size and functional parameters.
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Affiliation(s)
- Attila Nemes
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Tamás Forster
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
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Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Nemes A. [Correlations between mitral annular and left atrial function as assessed by three-dimensional speckle-tracking echocardiography in healthy volunteers. Results from the MAGYAR-Healthy Study]. Orv Hetil 2014; 155:1517-23. [PMID: 25217768 DOI: 10.1556/oh.2014.29975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Left atrium is a heart chamber with dinamic motion communicating with left ventricle through the mitral valve and its annulus. AIM The aim of the present study was to analyse whether relationships could exist between three-dimensional speckle-tracking echocardiography-derived morphologic and functional parameters of the left atrium and mitral annulus in healthy subjects. METHOD The present study comprised 35 healthy volunteers. Maximum (Vmax) and minimum (Vmin) left atrial volumes and left atrial volume before atrial contraction (VpreA) were measured, and several functional parameters based on these volumes were calculated in all cases. Morphologic and functional characteristics of the mitral annulus were also determined. RESULTS While Vmax showed correlations with both systolic and diastolic mitral annulus parameters, Vmin-VpreA correlated with only systolic ones. While total left atrial stroke volume correlated with both systolic and diastolic mitral annular parameters, passive left atrial stroke volume showed correlations only with diastolic ones. CONCLUSIONS Correlations exist between left atrial and mitral annular morphological and functional characteristics in healthy subjects.
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Affiliation(s)
- Péter Domsik
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Anita Kalapos
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Csaba Lengyel
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ I. Belgyógyászati Klinika Szeged
| | - Andrea Orosz
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Farmakológiai és Farmakoterápiás Intézet Szeged
| | - Tamás Forster
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
| | - Attila Nemes
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
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Santos ABS, Kraigher-Krainer E, Gupta DK, Claggett B, Zile MR, Pieske B, Voors AA, Lefkowitz M, Bransford T, Shi V, Packer M, McMurray JJV, Shah AM, Solomon SD. Impaired left atrial function in heart failure with preserved ejection fraction. Eur J Heart Fail 2014; 16:1096-103. [PMID: 25138249 DOI: 10.1002/ejhf.147] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/12/2014] [Accepted: 07/04/2014] [Indexed: 01/08/2023] Open
Abstract
AIMS Left atrial (LA) enlargement is present in the majority of heart failure with preserved ejection fraction (HFpEF) patients and is a marker of risk. However, the importance of LA function in HFpEF is less well understood. METHODS AND RESULTS The PARAMOUNT trial enrolled HFpEF patients (LVEF ≥45%, NT-proBNP >400 pg/mL). We assessed LA reservoir, conduit, and pump function using two-dimensional volume indices and speckle tracking echocardiography in 135 HFpEF patients in sinus rhythm at the time of echocardiography and 40 healthy controls of similar age and gender. Systolic LA strain was related to clinical characteristics and measures of cardiac structure and function. Compared with controls, HFpEF patients had worse LA reservoir, conduit, and pump function. The differences in systolic LA strain (controls 39.2 ± 6.6% vs. HFpEF 24.6 ± 7.3%) between groups remained significant after adjustments and even in the subsets of HFpEF patients with normal LA size or without a history of AF. Among HFpEF patients, lower systolic LA strain was associated with higher prevalence of prior HF hospitalization and history of AF, as well as worse LV systolic function, and higher LV mass and LA volume. However, NT-proBNP and E/E' were similar across the quartiles of LA function. CONCLUSIONS In this HFpEF cohort, we observed impairment in all phases of LA function, and systolic LA strain was decreased independent of LA size or history of AF. LA dysfunction may be a marker of severity and play a pathophysiological role in HFpEF. TRIAL REGISTRATION NCT00887588.
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Affiliation(s)
- Angela B S Santos
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA; Postgraduate Program in Cardiovascular Sciences, Cardiology, Federal University of Rio Grande do Sul, Brazil
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Comparison between left atrial features in well-controlled hypertensive patients and normal subjects assessed by three-dimensional speckle tracking echocardiography. J Cardiol 2014; 63:291-5. [DOI: 10.1016/j.jjcc.2013.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 09/09/2013] [Accepted: 09/16/2013] [Indexed: 10/26/2022]
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Aksoy S, Durmuş G, Özcan S, Toprak E, Gurkan U, Oz D, Canga Y, Karatas B, Duman D. Is left ventricular diastolic dysfunction independent from presence of hypertension in metabolic syndrome? An echocardiographic study. J Cardiol 2014; 64:194-8. [PMID: 24525047 DOI: 10.1016/j.jjcc.2014.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 12/04/2013] [Accepted: 01/06/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND It has been shown that left ventricular diastolic dysfunction (LVDD) develops in patients with metabolic syndrome (MetS). However, there is not sufficient evidence in the literature to determine whether this condition is due to increase in blood pressure, which is frequently encountered in MetS. The purpose of this study was to test the hypothesis whether LVDD in MetS is independent from the presence of hypertension. METHODS A total of 60 patients diagnosed with MetS and 30 healthy people, who were age- and gender-matched with the patient group, were included in the study as the control group. In the study group, 30 of the patients were normotensive whereas the other 30 had hypertension. Conventional echocardiographic examinations and tissue Doppler imaging were performed besides measurements of demographic and biochemical parameters. RESULTS In the hypertensive MetS group, early diastolic filling flow (E), early diastolic mitral annular velocity (E'), and E/A ratio were significantly lower compared to the control group. Late diastolic filling flow (A), deceleration time (DT), late diastolic mitral annular velocity (A'), and E/E' ratio were higher in the hypertensive MetS group than the control group. In the normotensive MetS group, E, E', and E/A ratio were also lower compared to the control group whereas DT, A', and E/E' ratio were higher. CONCLUSION These findings support the idea that LVDD may develop in patients with MetS even in the absence of hypertension. In addition, co-existence of hypertension with MetS contributes to further worsening of diastolic functions.
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Affiliation(s)
- Sukru Aksoy
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
| | - Gündüz Durmuş
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Serhan Özcan
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ercan Toprak
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ufuk Gurkan
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Dilaver Oz
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Yigit Canga
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Baran Karatas
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Dursun Duman
- Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
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Nemes A, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T. Comparison of three-dimensional speckle tracking echocardiography and two-dimensional echocardiography for evaluation of left atrial size and function in healthy volunteers (results from the MAGYAR-Healthy study). Echocardiography 2013; 31:865-71. [PMID: 24341394 DOI: 10.1111/echo.12485] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Noninvasive accurate assessment of left atrial (LA) size and function is an essential requirement in daily clinical practice. Real time three-dimensional (3D) echocardiography (RT3DE) with direct volumetric method has been found to be a highly accurate and reproducible noninvasive tool for the evaluation of LA dimensions and functional properties. Three-dimensional speckle tracking echocardiography (3DSTE) has just been introduced for volumetric assessments, which uses different, as called "block-matching" algorithm by strain analysis. This study was designed to compare two-dimensional (2D) echocardiography with 3DSTE for calculation of LA volumes and assessment of LA functional properties in healthy subjects. METHODS This study comprised of randomly selected 35 healthy subjects (40.9 ± 10.9 years, 20 men) in sinus rhythm, they all had undergone standard transthoracic 2D echocardiographic Doppler study extended with 3DSTE. RESULTS Two-dimensional echocardiography- and 3DSTE-derived minimum (Vmin ) and maximum (Vmax ) LA volumes and LA volume before atrial contraction (Vpre A ) did not differ significantly. Calculated functional LA properties were also compared. Good correlations were found between both techniques for Vmax (r = 0.93, P < 0.0001), Vmin (r = 0.62, P < 0.0001), and Vpre A (r = 0.74, P < 0.0001). CONCLUSIONS It may be stated that 3DSTE seems to be feasible in detection of cyclic changes in LA volumes and calculation of its functional properties is comparable to 2D echocardiography.
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Affiliation(s)
- Attila Nemes
- 2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
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