title: Left atrial expansion index is an independent predictor of diastolic dysfunction in patients with preserved left ventricular systolic function: a three dimensional echocardiography study.
abstract: In the absence of mitral valve disease left atrial (LA) volume is a marker of diastolic dysfunction and its severity. This study investigated the relationship between left ventricular (LV) end diastolic pressure (LVEDP) and LA volumes and phasic atrial functions detected by real-time full volume three-dimensional echocardiography (RT3DE), in a patient population with preserved LV systolic function. Seventy-two (39 female and 33 male; mean age 56.1 ± 9.0 years) stable patients with normal LV ejection fraction (EF) undergoing cardiac catheterization were studied. All patients underwent comprehensive echocardiographic examination just before catheterization and LVEDP was obtained. In addition to conventional echocardiographic measurements and Doppler indices; by using RT3DE LA maximum, minimum and pre-a-wave volumes were measured; LA total, passive and active emptying volumes and fractions were calculated. LV systolic function was assessed by EF and global longitudinal strain by speckle tracking. RT3DE minimum LA volume index, RT3DE active LAEF and LA expansion index (EI) were statistically significant univariate predictors of LVEDP ≥ 16 mmHg. When age and hypertension adjusted multivariate analysis was performed EI [β = -1.741, p = 0.015; OR 0.175; 95 % CI (0.043-0.717)] was an independent predictor of elevated LVEDP. RT3DE evaluation of LA function during entire cardiac cycle has incremental value for the diagnosis of diastolic dysfunction in patients with preserved EF. We suggest that RT3DE evaluation of LA may find clinical application in this field.
authors: Department of Cardiology, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey, suzan_hatipoglu@hotmail.com.
authors: Suzan
authors: S
authors: Hatipoglu
authors: Nihal
authors: N
authors: Ozdemir
authors: Gamze
authors: G
authors: Babur Guler
authors: Mehmet Onur
authors: MO
authors: Omaygenc
authors: Ruken Bengi
authors: RB
authors: Bakal
authors: Gokhan
authors: G
authors: Kahveci
authors: Tuba
authors: T
authors: Unkun
authors: Gulsum
authors: G
authors: Sahin
authors: Cihangir
authors: C
authors: Kaymaz
mesh_terms: D000367:Age Factors; D000368:Aged; D016279:Atrial Function, Left; D006328:Cardiac Catheterization; D003971:Diastole; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left; D017725:Ventricular Pressure