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Hafez MS, El Missiri AM. Left Atrial Ejection Force as a Marker for the Diagnosis of Heart Failure with Preserved Ejection Fraction. J Cardiovasc Echogr 2021; 31:125-130. [PMID: 34900546 PMCID: PMC8603775 DOI: 10.4103/jcecho.jcecho_142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/20/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: Several echocardiographic techniques are used to diagnose heart failure with preserved ejection fraction (HFPEF). Left atrial ejection force (LAEF) is a measure of left atrial (LA) systolic function. The aim of this study was to examine the use of LAEF as a measure for the diagnosis of HFPEF. Methods: A prospective study including 100 patients with HFPEF and 100 healthy controls. Heart failure association algorithm score for the diagnosis of HFPEF (HFA–PEFF score) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were assessed. Transthoracic echocardiography measured indexed left ventricular mass index (LVMI), left ventricular (LV) ejection fraction, LA volume index (LAVI), global longitudinal strain (GLS), trans-mitral Doppler velocities, E/A ratio, E/e' ratio, and estimation of LAEF. Results: Patients in the HFPEF group were more frequently hypertensive, diabetic, and had a history of ischemic heart disease. NT-pro-BNP was higher in the HFPEF group (P < 0.0001). LVMI, relative wall thickness, and LAVI were all significantly higher in the HFpEF group (P < 0.0001 for all). LV-GLS was significantly lower in the HFPEF (P < 0.0001). LAEF was significantly higher in the study group 142.14 ± 24.27 versus 92.18% ±13.99% (P < 0.0001). A sub-group of 18 patients in the study group with a borderline HFA-PEF score of 4 had a LAEF that was significantly higher than the control group (P < 0.0001) but did not differ from the rest of the HFPEFF group patients. Conclusion: LAEF was significantly higher in patients with HFPEF compared to healthy controls. Patients with a borderline HFA-PEFF score of 4 had a significantly higher LAEF as compared to controls.
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Malakan Rad E, Sheykhian T, Zeinaloo AA. Atrial and ventricular ejection force of the fetal heart: Which of the four chambers is the dominant? Ann Pediatr Cardiol 2019; 12:220-227. [PMID: 31516278 PMCID: PMC6716320 DOI: 10.4103/apc.apc_146_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background/Aim: This study aimed to measure and compare the ejection force of the cardiac chambers in healthy singleton fetuses and to investigate the relationship of ejection force of cardiac chambers with gestational age, fetal sex, and fetal heart rate. Patients and Methods: A prospective study was performed on 68 singleton fetuses with a gestational age of 17–34 weeks. Atrial and ventricular ejection force was measured. Measurements were repeated in 18 of the fetuses to assess intraobserver reliability. Results: The right atrium had the highest ejection force of all the cardiac chambers. Ejection force of both atria and ventricles increased with gestational age. Conclusion: The right atrium is the dominant chamber of the fetal heart in 17–34 weeks of gestation. Comparison of our values with previous studies indicates that left atrial ejection force almost doubles in the 1st month after birth. This study highlights the crucial role of the right atrium in the fetal cardiac function during 17–34 weeks of gestation.
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Affiliation(s)
- Elaheh Malakan Rad
- Department of Pediatric Cardiology, Children's Medical Center (The Pediatric Center of Excellence), Affiliated to Tehran University of Medical Sciences, Tehran, Iran
| | - Toktam Sheykhian
- Department of Pediatric Cardiology, Children's Medical Center (The Pediatric Center of Excellence), Affiliated to Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Zeinaloo
- Department of Pediatric Cardiology, Children's Medical Center (The Pediatric Center of Excellence), Affiliated to Tehran University of Medical Sciences, Tehran, Iran
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Zhong L, Tan LK, Finn CJ, Ghista D, Liew R, Ding ZP. Effects of Age and Gender on Left Atrial Ejection Force and Volume from Real-Time Three-Dimensional Echocardiography. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n4p161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: This study was carried out to (i) provide the methodology for determining left atrial (LA) volume, emptying fraction and ejection force (LAEF), from real-time 3-dimensional echocardiography (RT3DE), and (ii) evaluate the effects of age and gender on LA volume and LAEF in a wide age range of healthy participants. Materials and Methods: RT3DE was performed in 102 healthy participants (age range, 20 to 80 years). From full-volume data sets, LA endocardial borders were automatically traced and LA volumes were determined. LAEF was calculated as 1/3×mitral annular area × (blood density) × (peak velocity of A wave)2 according to Newton’s law of motion and hydrodynamics; wherein the mitral annular area (MVA) is traced using RT3DE and A is the peak Doppler-derived blood velocity at atrial systole with the sample volume placed at the mitral annulus level. Results: ANOVA analysis revealed that LA volume indices were significantly correlated with age (r = 0.366, P <0.0001 for maximal volume index and r = 0.288, P <0.005 for minimal volume index). LAEF was also significantly positively correlated with age (r = 0.49, P <0.0001). The LA emptying fraction was maintained across ages. LA volume indices and LAEF did not differ significantly with gender. Conclusion: Our data can be used as normal reference values for LA volumes and LAEF. We have demonstrated that age is positively related to LA volume indices and LAEF, which suggests that age-dependent cut-off values should be considered in those with heart disease.
Key words: Age, LA Ejection Force, RT3DE, Volume
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Affiliation(s)
| | | | - Chris J Finn
- Sir Charles Gairdner Hospital Perth, WA, Australia
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Nemes A, Anwar AM, Caliskan K, Soliman OII, van Dalen BM, Geleijnse ML, ten Cate FJ. Evaluation of left atrial systolic function in noncompaction cardiomyopathy by real-time three-dimensional echocardiography. Int J Cardiovasc Imaging 2007; 24:237-42. [PMID: 17849237 PMCID: PMC2233707 DOI: 10.1007/s10554-007-9261-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Accepted: 08/20/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Noncompaction cardiomyopathy (NCCM) is a rare disorder with persistance of the embryonic pattern of myoarchitecture. NCCM is characterized by loosened, spongy myocardium associated with a high incidence of systolic and diastolic left ventricular (LV) dysfunction and heart failure (HF). It is known that LV dysfunction contributes to elevated left atrial (LA) and pulmonary vascular pressures, however atrial function has not been examined in NCCM. The objective of the present study was to assess LA systolic function characterized by LA ejection force (LAEF) in NCCM patients using real-time three-dimensional echocardiography (RT3DE) and to compare to control subjects. METHODS The study comprised 17 patients with an established diagnosis of NCCM and their results were compared to 17 healthy age-matched controls with no evidence of cardiovascular disease. Forty-one percent of NCCM patients were in NYHA functional class II / III HF. Previously proposed echocardiographic diagnostic criteria for NCCM were used. All patients underwent conventional two-dimensional echocardiography and RT3DE. LAEF was measured based on MA annulus diameter (LAEF 3D-MAD) and area (LAEF 3D-MAA) using RT3DE. RESULTS The presence and severity of mitral regurgitation were more frequent in NCCM patients than in control subjects. LV diameters and mitral annulus were significantly increased in NCCM patients. Compared with control subjects, both LAEF 3D-MAD (3.8 +/- 2.2 vs 2.3 +/- 1.0 kdyne, P < 0.05) and LAEF 3D-MAA (12.7 +/- 7.6 vs 4.9 +/- 2.1 kdyne, P < 0.01) were significantly increased in NCCM patients. CONCLUSIONS LAEF as a characteristic of LA systolic function is increased in NCCM patients compared to normal individuals. These results can suggest compensating left atrial work against the dysfunctional LV in NCCM patients.
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Affiliation(s)
- Attila Nemes
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | - Ashraf M. Anwar
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- Department of Cardiology, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt
| | - Kadir Caliskan
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Osama I. I. Soliman
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
- Department of Cardiology, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt
| | - Bas M. van Dalen
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Marcel L. Geleijnse
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
| | - Folkert J. ten Cate
- Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, Room Ba304, Rotterdam, The Netherlands
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