How should we measure left atrium size and function?

2012 ◽  
Vol 40 (3) ◽  
pp. 155-166 ◽  
Author(s):  
Enrico Vizzardi ◽  
Antonio D'Aloia ◽  
Elena Rocco ◽  
Laura Lupi ◽  
Riccardo Rovetta ◽  
...  
2014 ◽  
Vol 155 (41) ◽  
pp. 1624-1631 ◽  
Author(s):  
Attila Nemes ◽  
Tamás Forster

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. Orv. Hetil., 2014. 155(41), 1624–1631.


Author(s):  
Alexander Sokolov ◽  
Viktor Varvarenko ◽  
Evgeny Krivoshchekov ◽  
Andrey Smorgon

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group


Author(s):  
Pablo M. A. Pomerantzeff ◽  
Carlos M. A. Brandão ◽  
Marco A. V. Guedes ◽  
Noedir A. G. Stolf

A 21-year-old woman presented with congestive heart failure caused by congenital mitral and tricuspid insufficiency, associated with great left atrium enlargement. Transthoracic echo-cardiogram revealed heart dextroversion associated with mitral and tricuspid severe insufficiency and left atrium enlargement (14 cm), confirmed by magnetic resonance study. The left atrium was reduced by a tangential triangular resection of the posterior wall, between the pulmonary veins, suturing the edges of the left atrium with bovine pericardium strip reinforcement. Mitral and tricuspid valves were repaired. The postoperative course was uneventful, and the patient was discharged in the 15th postoperative day. A control magnetic resonance study revealed a 50% reduction in left atrium size. Evolution of left atrium resection is excellent, with low recurrence of arrhythmias, embolism, or heart failure.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Buffle ◽  
A Neagoe ◽  
L Raio ◽  
S F Rimoldi ◽  
F H Messerli ◽  
...  

Abstract Introduction Preeclampsia (PE) is a multisystem disease affecting 2–8% of all pregnancies. Recently we found that the prevalence of antiphospholipid syndrome (APS) in PE patients at 13.9%. APS can be the cause of thromboembolic pulmonary hypertension. However, data on heart function and pulmonary pressure in PE and in PE with APS are sparse. Purpose We sought to investigate cardiac hemodynamics in this population. Method Between July 2016 and December 2018, we performed echocardiography in patients who had suffered from PE alone (n=102, age=32.6±4.8 y) or PE with APS (n=21, age=32.1±4.2 y) 3 months after delivery. APS was diagnosed according to the Sapporo criteria. Results The overall prevalence of APS was 17%. Right ventricular to right atrial pressure (RV/RA) gradient was significantly higher in PE + APS patients than in patients who had PE only (21.1±3.8 vs. 17.9±4.6mmHg, p=0.04, PE+APS vs. PE). The indexed volume of the left atrium (LA: 20.3±4.4 vs 23.5±5.5ml/m2, p=0.01, PE+APS vs. PE) and the birthweight of the newborn (1379.8±759.1 vs 1848.1±879.6.1g, p=0.02, PE+APS vs. PE) were lower in APS patients. Conclusion In patients with preeclampsia and APS, three month after delivery, pulmonary artery pressure was higher and the left atrium size smaller than in patients who had PE only. Conceivably this may reflects multiple subclinical clots in the pulmonary vessels in APS patients and may put these patients at an elevated risk of pulmonary hypertension later in life.


2017 ◽  
pp. 39-55 ◽  
Author(s):  
V. I. Gurina ◽  
E. V. Kondrat’ev ◽  
A. Sh. Revishvily ◽  
M. Z. Alimurzaeva

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Сatheter ablation (CA) of arrhythmogenic foci is supposed to be an established treatment option for symptomatic  patients with AF, refractory to antiarrhythmic therapy. Pre-procedural imaging is indispensable for the assessment of left atrium,  pulmonary veins and adjacent anatomy, and facilitates selection of  the ablation strategy to achieve an optimal result and minimize the risk of complications.Purpose: to evaluate the role of contrast-enhanced MDCT in  patients with AF; also to present the prospects for further  development of this method according to the systemic review of world research data.Materials and methods. 140 free access articles requested as  “MDCT left atrium”, “MDCT pulmonary veins”, “MDCT atrial  appendage” from 01.2009 until 01.2017 were analyzed in PubMed,  as well as a number of Russianlanguage articles in eLibrary.Results.This literature review reports and systematizes available  data on epidemiology and mechanisms of AF, represents current  classification. In addition were analyzed advantages of MDCT over  other methods of visualization while planning the CA and follow-up.Conclusion.MDCT is precise, effective and accessible option, which  satisfies visualization requirements during the preparation for CA.  Moreover, using MDCT in combination with electro-mapping systems  increases safety and effectiveness of the procedure. In postoperative period MDCT can be used for complications diagnostic and results assessment.


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