Key result
Ischemic heart disease with impaired LV function is linked to ~36% lower LA wall contraction velocity.
Why the study?
The role of left atrial contractility and its relation to active emptying markers in ischemic heart disease patients with impaired LV systolic function was not well characterized.
Case-Control (n=100)
In patients with ischemic heart disease and LV systolic dysfunction, left atrial wall contractility is reduced despite enhanced left atrial active emptying fraction and stroke volume index.
Reduced LA contraction velocity may indicate intrinsic atrial impairment in IHD with LV dysfunction; leaves open prognostic or therapeutic relevance.
Background: Left atrial (LA) active emptying plays an important role in left ventricular (LV) filling. It not only depends on LA preload but also on LA contractility. Our aim was to assess LA wall contraction velocity (LAWV) and its relation to each of LA active stroke volume index (LAASVI) and LA active emptying fraction (LAAEF) as markers of LA active emptying in patients with ischemic heart disease (IHD) and impaired LV systolic function. Methods: We studied 50 consecutive patients with stable IHD and LV ejection fraction <45% and 50 healthy controls. Standard echocardiography assessed: Biplane LV volumes and ejection fraction, trans-mitral Doppler E and A wave velocities and E/A ratio, indexed biplane LA volumes pre- and post-atrial contraction, LAASVI and LAAEF. LAWV was measured by tissue Doppler imaging. Results: Trans-mitral Doppler A velocity was lower in the study group 60.64 ± 20.6 vs 72.46 ± 17.13 cm/s (P = 0.002). Accordingly, E/A ratio was higher in the study group 1.32 ± 0.78 vs 0.92 ± 0.3 (P < 0.0001). Indexed biplane LAV-pre atrial contraction was larger in the study group 23.61 ± 3.8 vs 17.16 ± 3.57mL/m2 (P < 0.0001). Indexed biplane LAV-post atrial contraction was larger in the study group 16.22 ± 4.14 vs 13.19 ± 3.56mL/m2 (P=0.0002). Accordingly, biplane LAASVI was higher in the study 53 group 7.9 ± 1.26 vs 3.96 ± 0.63 mL/m2 (P<0.0001). LAAEF was larger in the study group 32.37 ± 8.89 vs 24.31 ± 7.12% (P < 0.0001). LAWV was lower in the study group 6.78 ± 0.51 vs 10.58 ± 0.67 cm/sec (P < 0.0001). Conclusion: In patients with IHD and impaired LV systolic function, LA wall contractility is reduced. However, LAASVI and LAAEF are enhanced.
No takes yet. Share an insight, caveat, or question.
Missiri et al. (2016) conducted a case-control in Ischemic heart disease with impaired LV systolic function (n=100). Ischemic heart disease with impaired LV systolic function vs. Healthy controls was evaluated on Left atrial wall contraction velocity (LAWV) (p=<0.0001). In patients with ischemic heart disease and impaired LV systolic function, left atrial wall contraction velocity was significantly reduced compared to healthy controls (6.78 vs 10.58 cm/sec, P<0.0001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: