Left atrial Frank–Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes
Population
70 patients
Design
Cross-sectional
Authors
Discussion
Loading...
Member takes
Implication
Supports LA Frank-Starling physiology on 3D echo; hypothesis-generating for atrial assessment and requires prospective validation.
Key Points
- To describe a left atrial Frank–Starling law by evaluating left atrial volume changes using real-time, three-dimensional echocardiography.
- Assessed left atrial volume (LAV) using real-time, three-dimensional echocardiography in 70 patients at end-systole (LAV max), end-diastole (LAV min), and pre-atrial contraction (LAV pre-A).
- Categorized patients into three groups according to LAV max: group I (<50 ml), group II (50–70 ml), and group III (>70 ml).
- Measured left atrial pump function by active atrial stroke volume (LAV pre-A – LAV min) and active atrial emptying fraction (active stroke volume / LAV pre-A × 100%).
- Active atrial stroke volume was significantly higher in group II than group I (mean [SD] 19.0 [9.2] vs 8.2 [4.9] ml, p<0.0001), but non-significantly lower in group III compared with group II (16.7 [12.5] vs 19.0 [9.2] ml).
- Active atrial stroke volume correlated with pre-atrial contraction volume (r = 0.56, p<0.001) but decreased at larger pre-contraction volumes.
- Active atrial emptying fraction was higher in group II than group I (43.1% [18.2] vs 33.2% [17.5], p<0.10) and significantly lower in group III compared with group II (26.2% [18.5] vs 43.1% [18.2], p<0.01).
Structured PICO
P
Population
70 patients
O
Outcome
Active atrial stroke volume (SV) and active atrial emptying fraction (EF)surrogate
Real-time 3D echocardiography demonstrates a Frank-Starling mechanism in the left atrium, where contractility increases with preload up to a certain volume before declining.
Cite This Study
Anwar et al. (2007) studied this question.