Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography

Alterations in left atrial (LA) and left ventricular (LV) compliance and arterial and coronary sinus atrial natriuretic factor (ANF) concentrations at baseline and in response to both volume depletion and expansion were investigated in 15 conscious dogs with aortic banding-induced LV hypertrophy (LVH) (LV/body wt increased by 64%), which also induced LAH (LA/body wt increased by 61%). With volume expansion coronary sinus ANF increased more (P < 0.05) in dogs with LVH (+427 +/- 88 pg/ml) compared with control dogs (+146 +/- 45 pg/ml). Arterial ANF levels also rose more with volume expansion in LVH. In dogs with LVH, the LV end-diastolic pressure-diameter relationship was shifted to the left with a steeper slope with volume expansion, such that at any given diastolic dimension, diastolic pressure was higher. In contrast, the pressure-dimension relationship for the LA appendage was shifted in the opposite direction during both atrial systolic and diastolic phases, with a more shallow slope in hypertrophy compared with control dogs, resulting in an augmented pressure-dimension product during volume loading in LAH. In conclusion, in dogs with LVH and LAH, enhanced ANF was revealed in the coronary sinus and systemic circulation during volume expansion, which could be due, in part, to a more compliant, but hypertrophied, LA, which responded to equivalent volume loading with an augmented pressure-dimension product.

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Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End-Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

Echocardiography ◽

10.1111/echo.13094 ◽

2015 ◽

Vol 33 (3) ◽

pp. 398-405 ◽

Cited By ~ 66

Author(s):

Matteo Cameli ◽

Stefania Sparla ◽

Maurizio Losito ◽

Francesca M. Righini ◽

Daniele Menci ◽

...

Keyword(s):

Ejection Fraction ◽

Left Atrial ◽

Diastolic Pressure ◽

Left Ventricular ◽

Left Atrial Strain ◽

Atrial Strain ◽

Invasive Measurement

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Comparing the Performance of Tissue Doppler versus Left Atrial Strain in Predicting Left Ventricular End Diastolic Pressure in Patients with Different Left Ventricular Ejection Fractions

Sohag Medical Journal ◽

10.21608/smj.2018.41318 ◽

2018 ◽

Vol 22 (1) ◽

pp. 213-221

Author(s):

Aliaa Mahfouz ◽

Mohammed Salama ◽

Ramadan Mohamed ◽

Mohamed Saleh

Keyword(s):

Left Atrial ◽

Diastolic Pressure ◽

Tissue Doppler ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Left Atrial Strain ◽

Atrial Strain

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P4351Validation by cardiac catheterization of noninvasive evaluation of left ventricular chamber and myocardial stiffness as a diastolic function using speckle tracking echocardiography

European Heart Journal ◽

10.1093/eurheartj/ehz745.0758 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Yoshizane ◽

R Tanaka ◽

M Kawasaki ◽

M Otsuka ◽

T Shoji ◽

...

Keyword(s):

Diastolic Function ◽

Cardiac Catheterization ◽

Left Atrial ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Diastolic Pressure ◽

Hypertensive Heart Disease ◽

Left Ventricular ◽

Minimum Volume ◽

Myocardial Stiffness

Abstract Background Left ventricular (LV) diastolic function is mainly composed of LV relaxation and LV stiffness. We reported that pulmonary capillary wedge pressure (ePCWP) and LV relaxation assessed by Tau (eTau) are noninvasively evaluated by speckle tracking echocardiography (STE). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau. Therefore, LV chamber stiffness (c-stiffness) may be assessed with the use of two LV diastolic pressure-volume coordinates: the mLVP and volume and the end-diastolic pressure (EDP) and volume. Purpose We sought to noninvasively assess LV stiffness using STE and validate the value by cardiac catheterization. Methods Echocardiography and catheterization were performed in 124 patients (age 72±8) (70 angina pectoris, 20 prior myocardial infarction, 19 hypertensive heart disease, 11 congestive heart failure and 4 paroxysmal atrial fibrillation). The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 × Log (left atrial active emptying function/minimum volume) and the eTau (ms) is obtained as isovolumic relaxation time/(ln 0.9 × systolic blood pressure − ln ePCWP) as previously reported. The mLVP (e-mLVP) was estimate using Tau. The estimated EDP (e-EDP) was calculated as 12.3 − 10.1 × Log (left atrial active emptying function / minimum volume). LV c-stiffness (mmHg/ml) was calculated as LV pressure change (from mLVP to EDP) obtained by catheterization divided by LV volume change during diastole which equals to stroke volume by echocardiography. Estimated c-stiffness (e-c-stiffness) was noninvasively obtained using e-mLVP and e-EDP. Furthermore, LV myocardial stiffness (m-stiffness) was calculated by LVED stress / LV longitudinal strain by STE, where LV stress (kdynes/cm2) was calculated as 0.334 × pressure × dimension / [thickness (1 + thickness/dimension)]. The estimated m-stiffness (e-m-stiffness) was calculated using e-EDP. Results The eTau and e-EDP estimated by STE had a good correlation with Tau and EDP invasively obtained by catheterization (r=0.75 and 0.63, respectively, both p<0.001). There was a good correlation between Tau and mLVP (Tau = 2.06 mLVP + 33.7, r=0.70). The estimated LVED stress had good correlation with ED stress obtained by catheterization (r=0.77, p<0.001). The e-c-stiffness and e-m-stiffness had a good correlation with those obtained by catheterization (e-c-stiffness; 0.116±0.07 and c-stiffness; 0.115±0.06, r=0.603, e-m-stiffness; 0.81±0.41 and m-stiffness; 0.85±0.45, r=0.89, respectively). Bland-Altman analysis revealed a good agreement between e-c-stiffness and c-stiffness, and between e-m-stiffness and m-stiffness without fixed and proportional bias. Conclusion This study demonstrated that LV stiffness may be noninvasively assessed by STE with reasonable accuracy and may have utility and value in the routine clinical practice for the diagnosis and treatment in patients with diastolic dysfunction.

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Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with normal left ventricular ejection fraction

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-020-01869-7 ◽

2020 ◽

Vol 36 (9) ◽

pp. 1659-1666 ◽

Cited By ~ 1

Author(s):

Jia-Li Fan ◽

Bo Su ◽

Xin Zhao ◽

Bing-Yuan Zhou ◽

Chang-Sheng Ma ◽

...

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Atrial ◽

Diastolic Pressure ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Left Atrial Strain ◽

Ventricular Ejection Fraction ◽

Normal Left Ventricular ◽

Atrial Strain

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Abstract 3360: Depressed Left Atrial Function and its Relation to Left Ventricular Filling Pressure in Systolic Heart Failure Patients.

Circulation ◽

10.1161/circ.116.suppl_16.ii_758 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Erberto Carluccio ◽

Macello Chinali ◽

Paolo Biagioli ◽

Daniela Girfoglio ◽

Marina De Marco ◽

...

Keyword(s):

Heart Failure ◽

Left Atrial ◽

Diastolic Pressure ◽

Nyha Class ◽

Systolic Heart Failure ◽

Tissue Doppler ◽

Left Ventricular ◽

Atrial Function ◽

Lv Function ◽

Filling Pattern

Background : In uncomplicated hypertensive patients with preserved left ventricular (LV) function, enhanced left atrial systolic force (LASF) is associated with LV hypertrophy. In contrast, in patients with prevalent cardiovascular disease, reduced LASF has been shown to be associated with incident atrial fibrillation and poor cardiovascular prognosis. To date the relation between LASF and LV filling pressures in patients with systolic heart failure (HF) has not been adequately investigated. Methods : Doppler echocardiographic measurements of LV systolic, diastolic, and Tissue-Doppler longitudinal function, were obtained in 108 patients (66±12 years; 20% women) with systolic HF [NYHA class III; ejection fraction <40% (mean EF%=27.7±7.7%)]. LASF was calculated from mitral orifice area and transmitral peak A velocity. Population study was dichotomized according to the presence or absence of restrictive filling pattern (RF), defined as DT <150 ms. LV end-diastolic pressure (LVEDP) was derived combining transmitral peak E velocity and tissue Doppler E’ (E/E’ ratio). Results : In the overall population, LASF averaged 10.7±5.8 kdynes. LASF was significantly reduced in patients showing RF (n = 43; 39.8% of study population) compared to non-RF patients (8.1±4.8 vs 12.5±5.8 kdynes, p<0.0001). Consistent with this finding, LVEDP was significantly higher in RF patients (p<0.001). In RF patients, LASF was correlated positively with EF% (r=0.23, p<0.05) and TD systolic peak velocity (r=0.39, p<0.0001), and negatively with isovolumic relaxation time (r=0.68, p<0.0001). In additional analysis comparing quartiles of LV end-diastolic pressure, LASF decreased with increasing quartiles of LV end-diastolic pressure (13.7±7 kdynes vs 12±7 kdynes vs 10.6±5 kdynes vs 8±4 kdynes; p for trend <0.01). Conclusions : In systolic HF patients in class NYHA III, left atrial systolic force is reduced in the presence of restrictive filling pattern due in part to increased LV end-diastolic pressure, also associated with reduced LV systolic performance. In CHF patients, increased LVEDP partially blunts LA atrial function, and might be considered as an index of atrial afterload.

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