Echocardiographic assessment of left atrial ejection force and kinetic energy in chronic heart failure.
BACKGROUND
There is limited information regarding left atrial (LA) systolic adaptation to chronic heart failure (HF) in humans. Therefore, the aim of our study was to determine the LA ejection force (LAEF) and kinetic energy in patients with HF.


RESULTS
58 HF patients (63.8% in NYHA II) and 48 controls were studied. LA volumes were echocardiographically determined using the biplane area-length method. LA systolic function was assessed with the: (a) active emptying volume (ACTEV) and fraction (ACTEF), (b) ejection force (kdynes/m2), calculated with Manning's method [LAEF = 0.5 * rho * mitral orifice area * A2; rho: blood density, Alpha: late transmitral flow velocity] and a modification incorporating parameters of LA function [LAEFm = 0.5 * rho * LA volume at onset of atrial systole * ACTEF * A2/VTl A], and (c) kinetic energy [LA-ke (kdynes.cm/m2) = 0.5 * rho * ACTEV * A2]. LA maximal volume and ACTEV were lower (42.9 +/- 14.4 vs. 59.7 +/- 14.7 cm3, P < 0.0001; 10.9 +/- 3.3 vs. 13 +/- 3.3 cm3, P = 0.0001, respectively), whereas ACTEF (%) was higher (36.3 +/- 7 vs. 29.3 +/- 7.6 cm3, P < 0.0001) in controls than HF. LAEF, LAEFm, and LA-ke were lower in controls than HF (7.68 +/- 5.1 vs. 10.16 +/- 3.7 kdynes/m2, P = 0.006; 3.63 +/- 2.05 vs. 5.02 +/- 1.74 kdynes/m2, P = 0.0004; 2.41 +/- 1.91 vs. 3.99 +/- 2.1 kdynes.cm/m2, P < 0.0004, respectively).


CONCLUSIONS
Despite the decreased LA systolic shortening, overall LA systolic performance is augmented in chronic HF due to LA dilation.
Triposkiadis
Filippos
F
Department of Cardiology, Larissa University Hospital, PO Box 1425, 411 10 Larissa, Greece. admin@triposkiadis.com
Harbas
Christos
C
Sitafidis
George
G
Skoularigis
John
J
Demopoulos
Vassilios
V
Kelepeshis
Glafkos
G
D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D016279:Atrial Function, Left; D002908:Chronic Disease; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008955:Models, Cardiovascular; D053580:Muscle Strength; D009200:Myocardial Contraction; D011446:Prospective Studies; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D012107:Research Design; D012720:Severity of Illness Index; D016277:Ventricular Function, Left