Why the study?
Are left atrial size, pressure, and ejection fraction useful in diagnosing left ventricle diastolic dysfunction noninvasively?
Are left atrial size, pressure, and ejection fraction useful in diagnosing left ventricle diastolic dysfunction noninvasively?
Left atrial pressure and maximum left atrial volume are useful noninvasive markers for evaluating left ventricular diastolic dysfunction, whereas left atrial ejection fraction is not.
May support LA parameters for noninvasive diastolic dysfunction assessment; leaves open prospective validation before practice change.
The purpose of this prospective study was to determine whether left atrial size, pressure, and ejection fraction are useful in diagnosing patients with left ventricle (LV) diastolic dysfunction through noninvasive means. Mitral valve and pulmonary vein Doppler measurements are used currently to diagnose LV diastolic dysfunction (LVDD). The left atrium (LA) influences these Doppler measurements. By coordinating Doppler and LA values, an understanding of the LA could help with LVDD patients. Thirty-four patients (15 men, 19 women; mean age 65.6 ± 14 years) were evaluated by echocardiography. M-mode of the left ventricle and mitral flow E/A ratio were used in determining LV diastolic dysfunction. Apical four- and two-chambers were measured to find left atrial volume and area. Left atrial ejection fraction (LAEF) was calculated as the percentage of blood expelled in a cycle. LA pressure evaluated through pulmonary wedge pressure was related to E/A wave velocity ratio ( P = 1.11E - 0 7 , r = .77). Maximum left atrial volume was significant in patients with mild LVH measurements ( P = .03, r = .53) and patients with E/A wave velocity ratio < 1.0 ( P = .02, r = .65). While LA pressure and maximum left atrial volumes prove to be useful in evaluating patients with LV diastolic dysfunction throughout this study, LAEF is not significant when correlated with these patients.
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Valentine et al. (2003) studied this question.
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