title: Effects of left ventricular systolic dysfunction on left atrial appendage and left atrial functions in patients with chronic nonvalvular atrial fibrillation.
abstract: OBJECTIVE
  It has been claimed that left ventricular (LV) systolic dysfunction impairs left atrial (LA) and left atrial appendage (LAA) functions. In this study, we compared the LA and LAA function parameters in patients with chronic nonvalvular atrial fibrillation (AF) with and without LV systolic dysfunction.
  
  
  RESULTS
  The study population consisted of 28 patients with chronic nonvalvularAF. Group I consisted of 12 patients with LV systolic dysfunction (mean age: 61 +/- 14 years; LV ejection fraction: 44 +/- 6%), group II of 16 patients with normal LV systolic function (mean age: 52 +/- 15 years; LV ejection fraction: 65 +/- 3%). LV ejection fraction (EF) was measured by echocardiography utilizing bi-plane area length method. The following LA and LAA transoesophageal echocardiography parameters were obtained: I) LA diameter, 2) LAA ejection velocity, 3) LAA filling velocity, 4) LAA ejection fraction, 5) pulmonary venous (PV) systolic velocity, 6) PV diastolic velocity, 7) PV systolic velocity/diastolic velocity ratio. The left atrium diameter was significantly larger in group I than in group 11 (4.7 +/- 0.7 cm vs. 3.8 +/- 0.6 cm, p < 0.05). The LAA ejection velocity and LAA ejection fraction were significantly lower in group I than in group 11 (22.6 +/- 15.5 cm/s vs 37.5 +/- 11.3 cm/s and 26.9 +/- 20.8% vs. 41.3 +/- 10.9%, p < 0.05 for both comparisons). The PV systolic velocity and PV systolic velocity/diastolic velocity ratio were significantly smaller in group I than in group II (26.2 +/- 14.8 cm/s vs. 51.5 +/- 22 cm/s and 0.7 +/- 0.6 vs. 1.2 +/- 0.5, p < 0.05 for both comparisons). Although decreased LAA filling and PV diastolic velocities were determined in group I, no significant difference existed between groups I and II. Thrombus and/or spontaneous echo contrast (SEC) in the LA and/or LAA were more frequent in group I (75% vs. 18%, p < 0.05).
  
  
  CONCLUSIONS
  These results indicate that LV systolic dysfunction impairs various LA and LA function parameters and is associated with an increased frequency of SEC and/or LA thrombus in patients with chronic nonvalvularAF.
authors: Gazi University School of Medicine, Department of Cardiology, Ankara, Turkey. mcemri@hotmail.com
authors: Mustafa
authors: M
authors: Cemri
authors: Timur
authors: T
authors: Timurkaynak
authors: Murat
authors: M
authors: Ozdemir
authors: Bülent
authors: B
authors: Boyaci
authors: Ridvan
authors: R
authors: Yalcin
authors: Atiye
authors: A
authors: Cengel
authors: Ovsev
authors: O
authors: Dörtlemez
authors: Halis
authors: H
authors: Dörtlemez
mesh_terms: D000328:Adult; D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D002908:Chronic Disease; D003971:Diastole / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*