Korean Circ J.  2009 Jul;39(7):280-287. 10.4070/kcj.2009.39.7.280.

Echocardiographic Assessments of Left Atrial Strain and Volume in Healthy Patients and Patients With Mitral Valvular Heart Disease by Tissue Doppler Imaging and 3-Dimensional Echocardiography

• Shin MS
• Kim BR
• Oh KJ
• Bong JM
• Chung WJ
• Kang WC
• Han SH
• Moon CI
• Ahn TH
• Choi IS
• Shin EK

• KMID: 2145564
• DOI: http://doi.org/10.4070/kcj.2009.39.7.280

Abstract

BACKGROUND AND OBJECTIVES
The purpose of the current study was to assess left atrial (LA) physiology in relation to associations between LA volume change and regional tissue velocities and strains, and to extend this information to patients with mitral stenosis (MS) or mitral regurgitation (MR). SUBJECTS AND METHODS: Twenty-two healthy persons, 22 patients with moderate-to-severe MS, and 22 patients with moderate-to-severe MR were studied. Tissue velocities, strains, and time-volume curves of the LA were acquired using tissue Doppler imaging and 3-dimensional echocardiography. RESULTS: In healthy controls, the maximal LA volume was negatively correlated with the posterior wall longitudinal systolic strain (r=-0.45, p=0.03). The time-to-maximal LA volume was positively correlated with the time-to-posterior wall longitudinal peak strain (r=0.46, p=0.03) and the time-to-circumferential peak strain (r=0.59, p=0.004). The LA active emptying fraction (LAactEF) was positively correlated with the posterior wall longitudinal peak systolic and late diastolic tissue velocities. In patients with MS, the maximal LA volume was negatively correlated with the posterior wall radial peak systolic velocity and the longitudinal late diastolic velocity. In patients with MS, the LAactEF had an additional positive correlation with the anterior wall longitudinal and circumferential systolic velocities, whereas the patients with MR had an additional positive correlation between the LAactEF and the lateral wall longitudinal peak strain as compared with the healthy cantrols. CONCLUSION: LA longitudinal and circumferential deformations are more related than radial deformation to determining LA volume and function. The LA of patients with MS revealed a greater pathologic physiology than those of patients with MR.

Keyword

Left atrium; Doppler; Strains

MeSH Terms

Echocardiography
Heart Atria
Heart Valve Diseases
Humans
Mitral Valve Insufficiency
Mitral Valve Stenosis
Sprains and Strains

Figure

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  Fig. 1 Left atrial (LA) time-volume curve obtained by real time 3-dimensional echocardiography.

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  Fig. 2 The maximal left atrial (LA) volume had a negative correlation with peak longitudinal strain of the LA posterior wall in the healthy group.

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  Fig. 3 Time-to-maximal left atrial (LA) volume had a positive correlation with the time-to-longitudinal peak strain of the LA posterior wall from the R wave of the ECG in the healthy group. ECG: electrocardiogram, long.: longitudinal.

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  Fig. 4 The time-to-maximal left atrial (LA) volume had a positive correlation with the time-to-circumferential peak strain of the LA from the R wave of the ECG in the healthy group. ECG: electrocardiogram, circum.: circumferential.

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