Evaluation of the Left Atrial Size and Function in Addition to Analysis of the Mitral and Pulmonary Venous Flow Velocity in the Estimation of Left Ventricular Filling Pressures

Lee, Hyeon Suk; Bak, Nam Kyu; Kim, Dae Soo; Chin, Young Joo; Park, Gook Tae; Kim, Dong Woon; Cho, Myeong Chan

Abstract

BACKGROUND
Mitral and pulmonary venous(PV) flow velocity variables are being used for the indirect evaluation of left ventricular(LV) diastolic function. However, these flow velocities are influenced by age, loading conditions and other factors. This study was designed to evaluate usefulness of left atrial size and function in addition to the relation of mitral and PV flow velocity variables in the estimation of LV filling pressures.
METHODS
Mitral and PV flow velocity variables. left artial size and function were assessed just before a cardiac catherization in 31 patients. According to the LV filling pressures, patients were divided into two subgroups and echocardiographic variables were compared.
RESULTS
1) LV end-diastolic pressure was related to the duration of reverse flow in the PV at atrial contraction(r=0.58) and difference in mitral and PV flow velocity duration at atrial contraction(r=0.54), and the similar findings were observed in other left ventricular filling pressures. 2) Left atrial size and volumes were greater in the subgroup of abnormal LV filling pressures(P < 0.05), but left atrial ejection fraction was not different between subgroups.
CONCLUSION
In addition to variables of the mitral and PV flow velocities, left atrial size and volume may provide an additive value in the estimation of left ventricular filling pressures.