scholarly journals Left atrial conduit function: A short review

2021 ◽  
Vol 9 (19) ◽  
Author(s):  
Paolo N. Marino
Keyword(s):  
Left Atrial ◽  
Short Review ◽  
Conduit Function

Left atrial systolic and diastolic function accompanying chronic rapid pacing-induced atrial failure

1998 ◽  
Vol 275 (1) ◽  
pp. H183-H189 ◽  
Author(s):  
Brian D. Hoit ◽  
Yanfu Shao ◽  
Marjorie Gabel
Keyword(s):  
Left Atrial ◽  
Time Derivative ◽  
Left Ventricular ◽  
Atrial Pacing ◽  
Reduced Ejection Fraction ◽  
Stiffness Constant ◽  
Ventricular Response ◽  
Rapid Pacing ◽  
Systolic And Diastolic Function ◽  
Conduit Function

The objective of this study was to examine the hypothesis that long-term, rapid atrial pacing produces a model of atrial systolic and diastolic dysfunction but does not alter ventricular function. Eight dogs were atrially paced at 400 beats/min (3:1–5:1 ventricular response) for 6 wk and subsequently instrumented with left atrial (LA) and left ventricular (LV) sonomicrometers and micromanometers. Data were compared with those from six sham-operated controls at matched heart rates and mean LA pressures of 10 mmHg. Dogs with rapid pacing had slightly greater LA volume (10.3 ± 4.0 vs. 7.9 ± 4.4 ml) and reduced ejection fraction (2.2 ± 1.4 vs. 13.0 ± 4.0, P < 0.05), systolic ejection rate (0.3 ± 0.1 vs. 2.8 ± 1.2 vol/s, P < 0.05), and reservoir fraction (0.07 ± 0.04 vs. 0.35 ± 0.06, P < 0.05) compared with controls. LA diastolic chamber stiffness was greater after rapid atrial pacing than before (stiffness constant k c, 5.7 ± 2.3 vs. 3.4 ± 0.6, P < 0.05), and the ratio of transesophageal echo-determined pulmonary venous systolic to diastolic integrated flow (a measure of relative reservoir to conduit function of the LA) was less in rapidly paced dogs compared with control dogs (0.41 ± 0.19 vs. 0.68 ± 0.23, P < 0.05). In contrast, rapid atrial pacing did not influence LV systolic performance or lusitropy, because the LV pressure time derivative and the time constant of LV relaxation were similar in both groups. In this model of isolated atrial myopathy, increased atrial stiffness and enhanced conduit function compensate for impaired atrial booster pump and reservoir functions.

Left atrial performance during exercise in endurance athletes: the impact of gender

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Simard ◽  
M Sanz-De La Garza ◽  
A Vaquer-Segui ◽  
I Blanco ◽  
S Prat-Gonzalez ◽  
...  
Keyword(s):  
Left Atrial ◽  
Female Athletes ◽  
Premenopausal Women ◽  
Underlying Mechanism ◽  
Cardiopulmonary Exercise Test ◽  
Endurance Athletes ◽  
Funding Source ◽  
Increased Risk ◽  
The Impact ◽  
Conduit Function

Abstract Background High-intensity endurance training is associated with an increased risk of atrial fibrillation (AF) in male athletes while it seems to have a protective effect for the development of atrial arrhythmias in female athletes. Mechanisms underlying this fact are unknown but a differential atrial adaptation to exercise may be involved. Aim To evaluate left atrial (LA) performance during exercise in endurance athletes (EAs) of both sexes. Methods Highly-trained (&gt;10 hours training/week) EAs performed a maximal cardiopulmonary exercise test. LA evaluation was performed at rest and immediately after exercise. LA analysis consisted of standard and speckle-tracking assessment: atrial contractile, reservoir and conduction strain. Results 80 EAs (55% women, 34.8±5.8 years) were enrolled. Baseline LA size and functional parameters were similar in both sexes (Table 1). Compared to men, women achieved a higher predicted VO2max (Δchange+11.9%, p&lt;0.01) but a similar increase of systolic blood pressure (Δ+63 vs +66%, p=0.58). Exercise induced a mild decrease in LA size but of similar amplitude for both sexes. LA strain parameters of EAs improved with exercise, but a significantly greater improvement in LA reservoir and conduit function was noted in women compared to men. In EAs with marked atrial remodelling (LA ≥35ml/m2), the same trend of greater improvement of LA reservoir and conduit function in women persisted. Conclusion In highly-trained EAs, premenopausal women have better LA function profile during exercise compared to men, even when the LA is significantly dilated. This discriminatory LA adaptation in female EAs could at least partly explain the dichotomous relationship between AF and exercise regarding sexes and warrants further studies to clarify the underlying mechanism. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Government of Spain - Plan Nacional I+D, Ministerio de Economia y Competitividad

Abstract P150: Association Of Leisure Time Physical Activity (LTPA) With Left Atrial Function In Older Adults: The Atherosclerosis Risk In Communities (ARIC) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Romil Parikh ◽  
Riccardo M Inciardi ◽  
Wendy Wang ◽  
Sheila M Hegde ◽  
Faye L Norby ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Diastolic Function ◽  
Left Atrial ◽  
Contractile Function ◽  
Left Ventricular ◽  
Volume Index ◽  
Aric Study ◽  
Lv Diastolic Function ◽  
Conduit Function

Introduction: Prior research indicates that higher LTPA is associated with better left ventricular (LV) diastolic function, but not with left atrial volume index (LAVI). Left atrial (LA) strain is a more sensitive marker of LA pathology. Hence, we evaluated association of LTPA with LA strain in the ARIC study, a community-based cohort study. Hypothesis: Higher LTPA is associated with better LA reservoir, conduit and contractile function. Methods: We included 4005 participants (mean age 75 years, 63% female, 21% black) with 2D echocardiographic (2DE) LA % strain data, LTPA data, and without prevalent coronary heart disease, valvular heart disease, heart failure, atrial fibrillation, and stroke at Visit 5 (V5, 2011-13). We estimated LTPA as metabolic equivalent-minutes per week from validated Baecke questionnaire and categorized it as poor, intermediate, or ideal as per AHA recommendation. We categorized change in LTPA from V3 (1993-95) to V5 as persistently poor (referent), decreasing, increasing, or persistently active. LA reservoir, conduit, and contractile % strain were measured from speckle-tracking 2DE. Linear regression was used to evaluate association of LTPA with LA function. We modeled LTPA (1) cross-sectionally at V5 as a continuous variable and (2) change from V3 to V5, as continuous and categorical variables (referent- persistently poor). Results: Higher LTPA at V5 (Table) and persistently high (vs poor) LTPA from V3 to 5 (β estimate -0.89, 95% CI -1.40, -0.38) were significantly associated with better LA conduit function after adjusting for CV risk factors, LV function, and LAVI. The same associations with LA reservoir function were no longer significant after adjusting for CV risk factors. LTPA was not associated with LA contractile function (Table). Conclusions: Consistent with LTPA’s salutary effect on LV diastolic function, higher LTPA is associated with better LA conduit function. Maintaining high LTPA from midlife to late-life may be beneficial in mitigating age-related changes in cardiac function.

Left atrial conduit function for left ventricular filling dynamics in patients with myocardial infarction

1989 ◽  
Vol 18 (2) ◽  
pp. 85-89 ◽  
Author(s):  
Yoichi Toma ◽  
Yasuo Matsuda ◽  
Kohshiro Moritani ◽  
Tsutomu Ryoke ◽  
Kazuhiro Katayama ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Filling ◽  
Ventricular Filling ◽  
Conduit Function

scholarly journals The Role of Left-Atrial Mechanics Assessed by Two-Dimensional Speckle-Tracking Echocardiography to Differentiate Hypertrophic Cardiomyopathy from Hypertensive Left-Ventricular Hypertrophy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 814
Author(s):  
Nicoleta-Monica Popa-Fotea ◽  
Miruna Mihaela Micheu ◽  
Nicoleta Oprescu ◽  
Adriana Alexandrescu ◽  
Maria Greavu ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Ventricular Hypertrophy ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Booster Pump ◽  
Conduit Function

Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different pathophysiology, but both can result in left-ventricular hypertrophy (LVH). The role of left-atrial (LA) functional changes detected by two-dimensional speckle-tracking echocardiography (STE) in indicating LVH etiology is unknown. Methods: We aimed to characterize LA mechanics using STE in LVH patients with HCM and HTN. LA 2D volumetric and STE parameters were analyzed in 86 LVH patients (43 HCM and 43 isolated HTN subjects) and 33 age- and sex-matched controls. Results: The volumetric study showed that LA reservoir and conduit function were impaired in the HCM group compared to controls, while, in the HTN group, only LA conduit function was deteriorated. The HCM group had all three STE-derived LA functions impaired compared to controls. The HTN group, consistently with volumetric analysis, had solely LA conduit function reduced compared to controls. Ratios of LA booster-pump strain (S) and strain rate (SR) to interventricular septum (IVS) thickness were the most accurate parameters to discriminate between HCM and HTN. The subgroup harboring sarcomeric pathogenic (P)/likely pathogenic (LP) variants had reduced LA booster-pump S and SR compared with the genotype-negative subgroup. Conclusions: LA reservoir, conduit, and pump functions are decreased in HCM compared to HTN patients with similar LVH. We report the ratios between LA contraction S/SR and IVS thickness as novel parameters with high accuracy in discriminating LVH due to HCM. The presence of P/LP variants in sarcomeric or sarcomeric-associated genes could be associated with more severe LA dysfunction.

scholarly journals Quantification of left atrial function in patients with non-obstructive hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking imaging: a feasibility and reproducibility study

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Yingxia Yang ◽  
Gang Yin ◽  
Yong Jiang ◽  
Lei Song ◽  
Shihua Zhao ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Ejection Fraction ◽  
Strain Rate ◽  
Left Atrial ◽  
Feature Tracking ◽  
Healthy Controls ◽  
Functional Parameters ◽  
Booster Pump ◽  
Conduit Function

Abstract Background Atrial fibrillation (AF) is the most common arrhythmia in hypertrophic cardiomyopathy (HCM) and is associated with adverse outcomes in HCM patients. Although the left atrial (LA) diameter has consistently been identified as a strong predictor of AF in HCM patients, the relationship between LA dysfunction and AF still remains unclear. The aim of this study is to evaluate the LA function in patients with non-obstructive HCM (NOHCM) utilizing cardiovascular magnetic resonance feature tracking (CMR-FT). Methods Thirty-three patients with NOHCM and 28 healthy controls were studied. The global and regional LA function and left ventricular (LV) function were compared between the two groups. The following LA global functional parameters were quantitively analyzed: reservoir function (total ejection fraction [LA total EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive ejection fraction [LA passive EF], passive strain [εe], peak early-negative SR [SRe]), and booster pump function (active ejection fraction [LA active EF], active strain [εa], peak late-negative SR [SRa]). The LA wall was automatically divided into 6 segments: anterior, antero-roof, inferior, septal, septal-roof and lateral. Three LA strain parameters (εs, εe, εa) and their corresponding strain rate parameters (SRs, SRe, SRa) during the reservoir, conduit and booster pump LA phases were segmentally measured and analyzed. Results The LA reservoir (LA total EF: 57.6 ± 8.2% vs. 63.9 ± 6.4%, p < 0.01; εs: 35.0 ± 12.0% vs. 41.5 ± 11.2%, p = 0.03; SRs: 1.3 ± 0.4 s− 1 vs. 1.5 ± 0.4 s− 1, p = 0.02) and conduit function (LA passive EF: 28.7 ± 9.1% vs. 37.1 ± 10.0%, p < 0.01; εe: 18.7 ± 7.9% vs. 25.9 ± 10.0%, p < 0.01; SRe: − 0.8 ± 0.3 s− 1 vs. -1.1 ± 0.4 s− 1, p < 0.01) were all impaired in patients with NOHCM when compared with healthy controls, while LA booster pump function was preserved. The LA segmental strain and strain rate analysis demonstrated that the εs, εe, SRe of inferior, SRs, SRe of septal-roof, and SRa of antero-roof walls (all p < 0.05) were all decreased in the NOHCM cohort. Correlations between LA functional parameters and LV conventional function and LA functional parameters and baseline parameters (age, body surface area and NYHA classification) were weak. The two strongest relations were between εs and LA total EF(r = 0.84, p < 0.01), εa and LA active EF (r = 0.83, p < 0.01). Conclusions Compared with healthy controls, patients with NOHCM have LA reservoir and conduit dysfunction, and regional LA deformation before LA enlargement. CMR-FT identifies LA dysfunction and deformation at an early stage.

scholarly journals Left atrial strain analysis in hypertensive heart disease and hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
L Ferri ◽  
S Pica ◽  
L Tondi ◽  
A Camporeale ◽  
R Arosio ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Heart Disease ◽  
Left Atrial ◽  
Feature Tracking ◽  
Hypertensive Heart Disease ◽  
Strain Analysis ◽  
Reservoir Function ◽  
Lv Mass ◽  
Atrial Strain ◽  
Conduit Function

Abstract Funding Acknowledgements Type of funding sources: None. Background Increasing evidence suggests that left atrial (LA) deformation is a sensitive marker of diastolic dysfunction in hypertrophic phenotypes. However, there is little data about the impact of hypertension on LA function; furthermore, LA deformation in hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) has not been compared yet.  Purpose The aim of this study is to compare atrial dimensions and function, evaluated by cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with HHD, HCM and healthy subjects (HS). Methods 67 patients (20 HHD, 27 HCM, 20 HS) underwent CMR and were included in the study. Patients were matched for age, sex and BSA; HHD and HCM were also comparable for LV mass index and ejection fraction (EF). CMR-FT atrial strain analysis was performed using Qstrain, Medis software to obtain i) LA conduit function, ii) LA booster pump function), iii) LA reservoir function, iv) LA volumes and EF. Tissue Doppler echocardiography was used to assess diastolic function, including E/e’. LA stiffness was calculated as the ratio between E/e’ and LA reservoir. Both focal and interstitial myocardial fibrosis were assessed with LGE and extracellular volume (ECV) quantification.  Results HHD and HCM showed impaired LA reservoir, conduit function and higher LA volumes vs HS (reservoir: 28 ± 11% and 28 ± 13% vs 41 ± 17%; conduit: 13 ± 7% and 13 ± 7% vs 22 ± 11%; LAESV: 76 ± 21 and 87 ± 22 vs 57 ± 19 ml respectively; all p ≤ 0.03). HHD and HCM were comparable for bi-ventricular morpho-functional parameters and ECV. HHD showed lower E/e’ values (8 ± 2 vs 16 ± 7, p = 0.002) and LA stiffness (0.23 ± 0.3 vs 0.74 ± 0.6, p 0.03), LA dimensions (LA area 13 ± 3 vs 16 ± 3 cm2/m2, p = 0.02 , LAESVi 41 ± 12 vs 48 ± 11 ml/m2, p = 0.05) and LGE extent (1 ± 2% vs 5 ± 5%, p = 0.001) as compared to HCM. Interestingly, HHD revealed a comparable reduced LA reservoir and conduit function (all p = 0.9) vs HCM.  In HHD patients LA reservoir function was correlated with E/e’ (r -0.8, p = 0.02), but not in HCM. Conversely, LA reservoir function was correlated with LV mass index in HCM (r -0.5, p &lt; 0.01).  Conclusions HHD patients showed a similar and significant impairment of LA function, with lower LA dimensions and E/e’ compared to HCM with similar LV mass index and preserved function. CMR-FT atrial strain analysis could represent a useful tool for HHD management, able to detect diastolic dysfunction (and/or atrial dysfunction) earlier than traditional markers. Further studies are needed to explore the relationship of LA deformation to heart failure symptoms and atrial fibrillation occurrence and potential changes related to response to therapy.

scholarly journals Assessment of Left Atrial Function in Essential Hypertension Patients With Normal Left Ventricle Function by Volume-derived Values and Two-dimensional Strain

2021 ◽  
Author(s):  
Jun Huang ◽  
Chao Yang ◽  
Zi-ning Yan ◽  
Li Fan ◽  
Cai-Fang Ni
Keyword(s):  
Essential Hypertension ◽  
Left Atrial ◽  
Speckle Tracking Echocardiography ◽  
Normal Subjects ◽  
Two Dimensional ◽  
Left Ventricle Function ◽  
Booster Pump ◽  
Conduit Function ◽  
Ventricle Function ◽  
Higher Sensitivity

Abstract Background: To investigate left atrial(LA) function in essential hypertension(EHT) patients by using volume-derived values, two-dimensional strain. Methods: 51 normal subjects and 95 EHT patients(without LVH: 50, and with LVH: 45) were enrolled for this research. LA Volume-derived index was measured in apical 4-, 2-chamber views by Simpson′s method. LA strain(S-reservoir, S-conduit, S-booster pump) and strain rate (SR-reservoir, SR-conduit, SR-booster pump), representing the reservoir, conduit and booster pump functions, respectively, were measured by two-dimensional speckle tracking echocardiography(STE).Results: Volume-derived values(contain Total LAEF, passive LAEF and active LAEF) and strain-derived values(S-reservoir, S-conduit, Sr-reservoir, Sr-conduit and Sr-booster pump) in EHT patients were significantly lower than normal subjects. Correlation test showed LA stiffness had a strong correlation with LA conduit function in EHT patients. The AUC values were higher for detection LA conduit function than LA reservoir and booster pump function in EHT patients. LA expansion index and LA stiffness also have the higher AUC with higher sensitivity and specificity values for detection the LA dysfunctions in EHT patients. Conclusions: In this study, we concluded that LA functions were damaged in EHT patients, which could be detect by LA volume-derived values and two-dimensional strain sensitively and reproductively. LA stiffness maybe a predictor for LV remodelling in EHT patients.

Sign in / Sign up

Export Citation Format

Share Document