scholarly journals P345 Temporal changes of left atrial function after orthotopic heart transplantation in a single-center prospective study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Z Dohy ◽  
C Czimbalmos ◽  
A Assabiny ◽  
Z Tarjanyi ◽  
Z Szakal-Toth ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Prospective Study ◽  
Left Atrium ◽  
Left Atrial ◽  
Temporal Changes ◽  
Left Ventricular ◽  
Atrial Function ◽  
Orthotopic Heart Transplantation ◽  
Control Group ◽  
And Function

Abstract Funding Acknowledgements Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary The geometry and function of the left atrium (LA) change after orthotopic heart transplantation (HTX) with bicaval technique, as the LA has a recipient part around the pulmonary veins and a donor part, and these often contract separately. Because of this altered LA function, the recognition of left ventricular diastolic dysfunction can be challenging. The standard echocardiographic diastolic parameters are often in abnormal range in HTX patients despite of normal left ventricular diastolic function. The aim of our prospective study was to investigate the LA volumes and function and their temporal changes after HTX using cardiac magnetic resonance (CMR). To better understand the cardiac characteristics of HTX patients, we started a prospective trial in January 2018. CMR was performed at one, three and six months after HTX. Left atrial contour detection was performed in 2- and 4-chamber views. Patients who had ≥Grade II allograft rejection before the CMR examination, were excluded (n = 2). In the remaining HTX patients (n = 21) and in a control group (n = 21) LA ejection fraction (EF), BSA-corrected maximum and minimum LA volume (Vi), stroke volume (SVi) were evaluated using bi-plane mode. LA global longitudinal strain (GLS) was defined with CMR based deformation imaging, called feature tracking. HTX patients had significantly higher LA volumes (maxLAVi 71 ± 22 vs. 47 ± 6 ml/m2, minLAVi 53 ± 22 vs. 18 ± 5 ml/m2) lower LASVi (19 ± 7 vs. 29 ± 4 ml/m2), LAEF (27 ± 10 vs. 62 ± 8%) and LA-GLS (8 ± 3 vs. 39 ± 10%) compared to the control group (p < 0.0001). Analysing the temporal changes in HTX patients, we found an increase in the LAEF (26 ± 8 vs. 30 ± 5%) and LA-GLS (8 ± 3 vs. 11 ± 3%) at three months (p < 0.05), there was no significant difference between the LA parameters at three and six months. Better understanding of the changes of left atrial function after HTX could help us to recognise pathological conditions. Abstract P345 Figure. Strain analysis of the left atrium

scholarly journals Temporal changes of left atrial function after orthotopic heart transplantation using cardiac magnetic resonance imaging in a single-center prospective study

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Z Dohy ◽  
L Szabo ◽  
C Czimbalmos ◽  
Z Szakal-Toth ◽  
N Parazs ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Heart Transplantation ◽  
Prospective Study ◽  
Left Atrial ◽  
Temporal Changes ◽  
Left Ventricular ◽  
Orthotopic Heart Transplantation ◽  
Control Group ◽  
And Function

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ÚNKP-19-3-I New National Excellence Program of the Ministry for Innovation and Technology; National Research, Development and Innovation Office of Hungary (NKFIA; NVKP_16-1-2016-0017 National Heart Program) Background The geometry and function of the left atrium (LA) change after orthotopic heart transplantation (HTX) with bicaval technique, as the LA has a recipient part around the pulmonary veins and a donor part, and these often contract separately. Because of this altered LA function, the recognition of left ventricular diastolic dysfunction can be challenging. The standard echocardiographic diastolic parameters are often in abnormal range in HTX patients despite of normal left ventricular diastolic function. Purpose The aim of our prospective study was to investigate the LA volumes and function and their temporal changes after HTX  using cardiac magnetic resonance (CMR). Method To better understand the cardiac characteristics of HTX patients, we started a prospective trial in January 2018. CMR was performed at one, three and six months after HTX. Left atrial contour detection was performed in 2- and 4-chamber views. Patients who had ≥Grade II allograft rejection before the CMR examination, were excluded (n = 6). In the remaining HTX patients (n = 37, 52 ± 12y, 29 male) and in a control group (n = 20, 49 ± 5y, 15 male) LA ejection fraction (EF), BSA-corrected maximum and minimum LA volume (Vi), stroke volume (SVi) were evaluated using bi-plane mode. LA global longitudinal strain (GLS) was defined with CMR based deformation imaging, called feature tracking. Results HTX patients had significantly higher LA volumes (maxLAVi 65 ± 22 vs. 46 ± 7 ml/m2, minLAVi 47 ± 21 vs. 18 ± 6 ml/m2) lower LASVi (19 ± 5 vs. 29 ± 4 ml/m2), LAEF (31 ± 10 vs. 62 ± 8%) and LA-GLS (10 ± 4 vs. 39 ± 11%) compared to the control group (p < 0.0001).  Analysing the temporal changes in HTX patients, we found an increase in the LA-GLS already at three months (10 ± 4 vs. 12 ± 3%, p < 0.05). The LAEF improved significantly at six months (29 ± 10 vs. 33 ± 10%, p < 0.05). Conclusion After HTX the LA volumes and function differ markedly from the normal population. The LA funcional parameters showed a moderate improvement after HTX. Better understanding the changes of left atrial function after HTX could help us to recognise  pathological conditions. Abstract Figure. Strain analysis of the left atrium

scholarly journals Left Atrial Shape and Function after Endovascular Device and Surgical Closure of ASDs in Children

2021 ◽  
Author(s):  
Alexander Sokolov ◽  
Viktor Varvarenko ◽  
Evgeny Krivoshchekov ◽  
Andrey Smorgon
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Surgical Correction ◽  
Control Group ◽  
Surgical Closure ◽  
Younger Age ◽  
Asd Closure ◽  
And Function ◽  
Endovascular Device

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group

scholarly journals Progress in the Study of the Left Atrial Function Index in Cardiovascular Disease: A Literature Review

2021 ◽  
Author(s):  
Yi Zhang
Keyword(s):  
Cardiovascular Disease ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Powerful Predictor ◽  
Function Index ◽  
Ventricular Structure ◽  
And Function ◽  
Valuable Predictor

Some studies have shown that left ventricular structure and function play an important role in the risk stratificationand prognosis of cardiovascular disease. The clinical application of left atrial function in cardiovascular disease has gradually attracted attention in the cardiovascular field. There are many traditional methods to evaluate left atrial function.Left atrial function related indexes measured by chocardiography has been identified as a powerful predictor of cardiovascular disease in recent years, but it has some limitations. The left atrial function index has been found to evaluate left atrial function more effectively than traditional parameters. Furthermore, it is a valuable predictor of therisk stratification and prognosis in patients with clinical cardiovascular disease such as heart failure, atrial fibrillation, hypertension, and coronary heart disease.

scholarly journals P1741 Echocardiographic assessment of rate versus rhythm control strategy in patients with persistent atrial fibrillation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Piatkowski ◽  
D A Kosior ◽  
J Kochanowski ◽  
M Szulc
Keyword(s):  
Control Strategy ◽  
Rate Control ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Left Ventricular ◽  
Rhythm Control ◽  
Control Group ◽  
And Function ◽  
Left Ventricular Morphology

Abstract BACKGROUND Patients with persistent atrial fibrillation (AF) can be managed with either rhythm or rate control strategy. The restoration and maintenance of the sinus rhythm (SR) is not superior to the rate control regarding the total mortality and the rate of thromboembolic complications. Data concerning the effect of these strategies on left ventricular morphology and function is missing. PURPOSE The objective of our prospective randomised multicenter study in patients with persistent AF was to evaluate the effect of these two approaches on left ventricular morphology and function. METHODS The study group consisted of 205 patients (F/M 71/134; mean age 60.8 ± 11.2 years), including 101 patients randomized to the rate control approach (Group I) and 104 patients randomized to SR restoration with cardioversion and subsequent antiarrhythmic drug treatment (Group II). Mean duration of AF was 231.8 ± 112.4 days. At the end of follow-up (12 months), SR was present in 64% of patients in Group II. Echocardiographic examination was performed at a baseline and at 2 and 12 months. In the rate-control group, both right (22.1 ± 4.1 vs. 23.2 ± 3.8 cm2; p < 0.05) and left atrial (25.9 ± 5.2 vs. 26.8 ± 4.6 cm2 p < 0.05) enlargement was observed during the 12 months follow-up. A significant decrease in right (21.8 ± 3.0 vs. 21.2 ± 3.5 cm2; p < 0.05) and left atrial (26.2 ± 4.6 vs. 25.5 ± 5.0 cm2; p < 0.05) size in the rhythm control arm was observed. Both strategies led to a significant increase in left ventricular fractional shortening (32.1 ± 7.3 vs. 34.2 ± 6.5% and 31.3 ± 6.7 vs. 35.5 ± 8.9%, respectively; p < 0.05). The comparison of the left ventricular end-diastolic diameter revealed no difference within and between groups (50.8 ± 5.6 mm vs. 52.2 mm ± 6.8 mm at a baseline and 50.0 ± 6.0 vs. 52.0 ± ± 7.4 mm at 12 months, respectively). In rhythm-control group such trend was observed only in pts. with successfully maintained SR. According to LV function improvement, rhythm-control strategy was preferred in pts. with hypertension (RR 2.63; 95% C.I.: 0.93-5.45; p < 0.05) or congestive heart failure in NYHA II or III class (RR 2.13; 95% C.I.: 0.98-4.42; p < 0.05). CONCLUSIONS Both strategies led to a significant increase in LV FS. Rate-control strategy led to right and left atrium enlargement, but rhythm control resulted in their decrease.

Improved left atrial transport and function with orthotopic heart transplantation by bicaval and pulmonary venous anastomoses

1995 ◽  
Vol 130 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Dov Freimark ◽  
Lawrence S.C. Czer ◽  
Ivan Aleksic ◽  
Cord Barthold ◽  
Dan Admon ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Left Atrial ◽  
Orthotopic Heart Transplantation ◽  
And Function

Size and function of left atrium in patient with heart failure with reduced ejection fraction

2019 ◽  
pp. 8-13
Author(s):  
Van Khanh Nguyen Truong ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Study Results ◽  
And Function

Background: Heart failure is a common clinical syndrome and is the final stage of most cardiovascular diseases. Nowadays, the role of left atrium in cardiovascular diseases, especially in HF diseases, is more and more important. At the early stage of heart failure, the size and pump function of left atrium are increased. When the left ventricular function is reduced significantly, left atrial function is alo impaired. Aims of the study: assess size and function of left atrium in patient with heart failure reduced ejection fraction (HFrEF). Establishing the association between two indexs above with some clinical and subclinical characteristics. Subjects and method: 51 HFrEF patients in Hospital of Hue University of Medicine and Pharmacy, who have including criteria. Cross-sectional study. Results: LAVI (ml/m2): 43.19 ± 12.48 ml/m2, percentage of large left atrial patents is 80.4%. LATEF (%): 31.93 ± 7.72%. LAVI has correlation with: LVEDV (r= 0,45); LVESV (r= 0,43); NT-proBNP (r= 0.371). There is a difference LAVI of diastolic dysfunction grades (r= 0.011), There is a difference LAVI of NYHA class (r= 0.016). LATEF has correlation with NTproBNP (r= -0.349). Conclusion: The left atrium’s size is increased and its function is reduced in HFrEF patient. There is a positive correlation between LAVI and LVEDV, LVESV, NTproBNP. The LAVI varies with the diastolic dysfunction grade. And there is a negative correlation between LATEF and NTproBNP. Key words: heart failure reduced ejection fraction; size of left atrium, function of left atrium

scholarly journals Left Atrial Dysfunction in Cardiac Amyloidosis and Hypertrophic Cardiomyopathy

2020 ◽  
Author(s):  
Shanshan Cui ◽  
Yueheng Wang ◽  
Hui Bai
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Cardiac Amyloidosis ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Control Group ◽  
Pump Function ◽  
Left Atrial Dysfunction ◽  
Conduit Function

Abstract This study aims to explore the changes of left atrial function in patients with cardiac amyloidosis (CA) by speckle tracking echocardiography (STE) and identify the difference of left atrial properties between patients with CA and those with hypertrophic cardiomyopathy (HCM). In this study, 16 patients with CA, 16 patients with HCM, and 16 age-matched healthy controls were enrolled. The time-dependent strain parameters (LASr, LAScd, and LASdt) and strain rate parameters (m-SRs, m-SRe, and m-SRa) of left atrial function were measured by STE in patients with CA, then were compared with that in patients with HCM. Compared with the control group, CA group showed significantly reduced LVEDV/BSA, LVESV/BSA, A, and GLS of the left ventricle, and significantly increased heart rate, IVSd, IVPWd, E, E/A, E/e', LAd and LAV/BSA. The left atrial reserve (LASr and m-SRs), conduit (LAScd and m-SRe) and pump (LASdt and mSRa) functions of CA group were significantly reduced compared with that of controls (P<0.05). The left atrial reserve and pump functions of CA group were significantly reduced compared with that of HCM group. In the CA group, the left atrial reserve function (LASr and m-SRs), conduit function (LAScd and m-SRe) and pump function (LASct and m-SRa) were all related to left ventricular GLS and E/e'. The reserve function, conduit function and pump function of left atrial in the CA group decreased significantly than that in the health control group. When comparing with HCM group, CA group showed reduced reserve function and pump function of left atrial. STE is a qualified technique for the diagnosis of CA.

Evaluation of left atrial size and function – from M-mode to 3D speckle-tracking echocardiography

2014 ◽  
Vol 155 (41) ◽  
pp. 1624-1631 ◽  
Author(s):  
Attila Nemes ◽  
Tamás Forster
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Functional Characterization ◽  
Left Atrial Size ◽  
Dynamic Motion ◽  
Heart Chamber ◽  
Atrial Size ◽  
Exact Measurement ◽  
Heart Cycle ◽  
And Function

Left atrium is not a passive heart chamber, because it has a dynamic motion respecting heart cycle and, in accordance with its stretching, it releases atrial natriuretic peptides. Since in the course of certain invasive procedures the size of left atrium may change substantially, its exact measurement and functional characterization are essential. The aim of the present review is to summarize echocardiographic methods for the assessment of left atrial size and functional parameters. Orv. Hetil., 2014. 155(41), 1624–1631.

Sign in / Sign up

Export Citation Format

Share Document