Estimation of Left Atrial Pump Function by Mitral Annular Velocity

BACKGROUND: Estimation of left atrial (LA) pump function is important for the management of cardiac patients. The purpose of this study is to elucidate the role of mitral annular late diastolic velocity (A') determined by transthoracic echocardiography as a parameter to predict LA pump function. METHODS AND RESULTS: One hundred and four consecutive patients that were scheduled for paroxysmal atrial fibrillation (AF) ablation, in whom both multi-detector computed tomography (MDCT) and echocardiography during sinus rhythm prior to ablation were performed, were enrolled in this study. To determine the echocardiographic parameters that most accurately represent LA pump function, the relationship between LA emptying fraction (LAEF) obtained by MDCT and echocardiographic parameters including A' were examined. A' was the only echocardiographic parameter that was significantly correlated with LAEF (r=0.59, P<0.0001). Receiver-operating characteristic curve analysis showed that when impaired LA booster pump performance was defined as an LAEF <30%, an A' cutoff value of 7.4 cm/s had a sensitivity of 93%, specificity of 81%, predictive accuracy of 83%, positive predictive value of 43% and a negative predictive value of 99%. CONCLUSIONS: A' is a simple, non-invasive and reliable method to estimate LA pump function in patients with paroxysmal AF.