title: Assessment of left atrial volume and function by real time three-dimensional echocardiography in obese patients.
abstract: OBJECTIVE
  To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP).
  
  
  METHODS
  This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function. Plasma NT-proANP was determined by ELISA method.
  
  
  RESULTS
  There was no significant difference between groups in left ventricular (LV) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume (LAVmax), LAVmax index (LAVI), LA minimal volume (LAVmin), before atrial contraction volume (LAVpreA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT-proANP levels were similar between groups. There were positive correlations between NT-proANP level and LAVI, LAVmax, LAVmin, LAVpreA, and LA total and active emptying volumes.
  
  
  CONCLUSIONS
  Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.
authors.affiliation: Clinic of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Julide
authors.initials: J
authors.lastname: Yagmur
authors.affiliation: Clinic of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cansel
authors.affiliation: Clinic of Cardiology, Malatya State Hospital, Malatya, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Kurtoglu
authors.affiliation: Clinic of Cardiology, Malatya State Hospital, Malatya, Turkey.
authors.forename: Siho
authors.initials: S
authors.lastname: Hidayet
authors.affiliation: Clinic of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Nusret
authors.initials: N
authors.lastname: Acıkgoz
authors.affiliation: Clinic of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Necip
authors.initials: N
authors.lastname: Ermis
authors.affiliation: Clinic of Medical Biochemistry, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozyalin
mesh_terms: D009320:Atrial Natriuretic Factor / Q000097:blood; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000503:physiopathology*; D011498:Protein Precursors / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor
keywords: echocardiography; left atrial volume; obesity