Assessment of atrial regional and global electromechanical function by tissue velocity echocardiography: a feasibility study on healthy individuals.
BACKGROUND
The appropriate evaluation of atrial electrical function is only possible by means of invasive electrophysiology techniques, which are expensive and therefore not suitable for widespread use. Mechanical atrial function is mainly determined from atrial volumes and volume-derived indices that are load-dependent, time-consuming and difficult to reproduce because they are observer-dependent.


OBJECTIVE
To assess the feasibility of tissue velocity echocardiography (TVE) to evaluate atrial electromechanical function in young, healthy volunteers.


METHODS
We studied 37 healthy individuals: 28 men and nine women with a mean age of 29 years (range 20-47). Standard two-dimensional (2-D) and Doppler echocardiograms with superimposed TVE images were performed. Standard echocardiographic images were digitized during three consecutive cardiac cycles in cine-loop format for off-line analysis. Several indices of regional atrial electrical and mechanical function were derived from both 2-D and TVE modalities.


RESULTS
Some TVE-derived variables indirectly reflected the atrial electrical activation that follows the known activation process as revealed by invasive electrophysiology. Regionally, the atrium shows an upward movement of its walls at the region near the atrio-ventricular ring with a reduction of this movement towards the upper levels of the atrial walls. The atrial mechanical function as assessed by several TVE-derived indices was quite similar in all left atrium (LA) walls. However, all such indices were higher in the right (RA) than the LA. There were no correlations between the 2-D- and TVE-derived variables expressing atrial mechanical function. Values of measurement error and repeatability were good for atrial mechanical function, but only acceptable for atrial electrical function.


CONCLUSIONS
TVE may provide a simple, easy to obtain, reproducible, repeatable and potentially clinically useful tool for quantifying atrial electromechanical function.
Quintana
Miguel
M
Department of Clinical Physiology, Karolinska University Hospital, Huddinge, The Karolinska Institute, Stockholm, Sweden. miguel.quintana@labmed.ki.se
Lindell
Peter
P
Saha
Samir K
SK
del Furia
Francesca
F
Lind
Britta
B
Govind
Satish
S
Brodin
Lars-Ake
LA
D016275:Atrial Function / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006329:Heart Conduction System / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009200:Myocardial Contraction / Q000502:physiology*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D016276:Ventricular Function
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