Value of assessment of left atrial volume and diameter in patients with heart failure but with normal left ventricular ejection fraction and mitral flow velocity pattern.
OBJECTIVE
We assessed the comparative value of measurements of tissue Doppler early diastolic mitral annular velocity (E'), left atrial diameter (LAD), and left atrial volume (LAV) in patients with possible heart failure (HF) but with normal left ventricular (LV) ejection fraction (EF) and mitral flow velocity pattern.


RESULTS
We determined LAV and LAD indexes in addition to the ratio of peak early diastolic mitral flow velocity (E) to E' (E/E' ratio) in 91 patients with all three of the followings: HF, LVEF of greater than 55%, and normal mitral E/A ratio between 0.8 and 1.5. Twenty healthy subjects were used as controls. E/E' ratio was abnormal (>1.5) in 38 of the 91 patients (sensitivity=44%). LAV index was 32 mL/m(2) or greater in 71 of the 91 patients (sensitivity=78%), while LAD index was 27 mm/m(2) or greater in 81 of 91 patients (sensitivity=89%). The area under the curve by receiver-operator curve analyses was 0.995 for LA volume index, 0.998 for LAD index, and 0.885 for E/E' ratio.


CONCLUSIONS
LAV and LAD indexes are more useful in detecting with HF and normal EF patients than E' related parameters.
Yoshida
Chikako
C
Cardiovascular Division, Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan.
Nakao
Shinji
S
Goda
Akiko
A
Naito
Yoshiro
Y
Matsumoto
Mika
M
Otsuka
Misato
M
Shimoshikiryo
Miho
M
Eguchi
Akiyo
A
Lee-Kawabata
Masaaki
M
Tsujino
Takeshi
T
Masuyama
Tohru
T
D003971:Diastole; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006325:Heart Atria / Q000473:pathology*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014463:Ultrasonography; D016277:Ventricular Function, Left