Left atrial conduit volume is generated by deviation from the constant-volume state of the left heart: a combined MRI-echocardiographic study

2004 ◽  
Vol 286 (6) ◽  
pp. H2416-H2424 ◽  
Author(s):  
Andrew W. Bowman ◽  
Sándor J. Kovács
Keyword(s):  
Flow Rate ◽  
Left Atrial ◽  
Left Ventricular ◽  
Constant Volume ◽  
Left Heart ◽  
Filling Rate ◽  
Average Flow Rate ◽  
Average Flow ◽  
Volume State ◽  
The Relationship

Although modeling the four-chambered heart as a constant-volume pump successfully predicts causal physiological relationships between cardiac indexes previously deemed unrelated, the real four-chambered heart slightly deviates from the constant-volume state by ventricular end systole. This deviation has consequences that affect chamber function, specifically, left atrial (LA) function. LA attributes have been characterized as booster pump, reservoir, and conduit functions, yet characterization of their temporal occurrence or their causal relationship to global heart function has been lacking. We investigated LA function in the context of the constant-volume attribute of the left heart in 10 normal subjects using cardiac magnetic resonance imaging (MRI) and contemporaneous Doppler echocardiography synchronized via ECG. Left ventricular (LV) and LA volumes as a function of time were determined via MRI. Transmitral flow, pulmonary vein (PV) flow, and lateral mitral annular velocity were recorded via echocardiography. The relationship between the MRI-determined diastolic LA conduit-volume (LACV) filling rate and systolic LA filling rate correlate well with the relationship between the echocardiographically determined average flow rate during the early portion of the PV D wave and the average flow rate during the PV S wave ( r = 0.76). We conclude that the end-systolic deviation from constant volume for the left heart requires the generation of the LACV during diastole. Because early rapid filling of the left ventricle is the driving force for LACV generation while the left atrium remains passive, it may be more appropriate to consider LACV to be a property of ventricular diastolic rather than atrial function.

A preliminary investigation of the freshwater red algae in streams of southern Ontario, Canada

1980 ◽  
Vol 58 (11) ◽  
pp. 1295-1318 ◽  
Author(s):  
Robert G. Sheath ◽  
Beverly J. Hymes
Keyword(s):  
Flow Rate ◽  
Red Algae ◽  
Preliminary Investigation ◽  
Average Flow Rate ◽  
Southern Ontario ◽  
Average Flow ◽  
Cell Organization ◽  
Conductivity Range ◽  
Freshwater Red Algae ◽  
The Relationship

Ten taxa of freshwater red algae have been observed in a survey of 62 streams and rivers within southern Ontario, Canada, over a period of 3 years. Five species are additions to the flora of Canada, Chroodactylon ramosum, Boldia erythrosiphon, Sirodotia tenuissima, Batrachospermum densum, and B. ectocarpum. In addition to these algae, Audouinella violacea, Sirodotia suecia, and Tuomeya fluviatilis are new observations within Ontario.Most of the Ontario red algae are restricted to streams or rivers with a minimum average flow rate of 10 m min−1. Audouinella violacea, B. moniliforme, and Lemanea fucina occur in a large number of streams which have a wide pH and conductivity range whereas S. tenuissima and B. ectocarpum are confined to one of the sites examined.Ultrastructural findings are reported concerning the cell organization of Boldia as well as the relationship between Batrachospermum plants and the "chantransia" stage. A key to the 10 taxa is included plus descriptions and a list of epiphytes of each alga are presented.

A Design Method for Thermosyphon Solar Domestic Hot Water Systems

1987 ◽  
Vol 109 (2) ◽  
pp. 150-155 ◽  
Author(s):  
M. P. Malkin ◽  
S. A. Klein ◽  
J. A. Duffie ◽  
A. B. Copsey
Keyword(s):  
Flow Rate ◽  
Design Method ◽  
Water Systems ◽  
Hot Water ◽  
Average Flow Rate ◽  
Domestic Hot Water ◽  
Average Flow ◽  
Solar Fraction ◽  
Wide Range ◽  
Flow Circuit

A modification to the f-Chart method has been developed to predict monthly and annual performance of thermosyphon solar domestic hot water systems. Stratification in the storage tank is accounted for through use of a modified collector loss coefficient. The varying flow rate throughout the day and year in a thermosyphon system is accounted for through use of a fixed monthly “equivalent average” flow rate. The “equivalent average” flow rate is that which balances the thermosyphon buoyancy driving force with the frictional losses in the flow circuit on a monthly average basis. Comparison between the annual solar fraction predited by the modified design method and TRNSYS simulations for a wide range of thermosyphon systems shows an RMS error of 2.6 percent.

scholarly journals Left atrial appendage orifice area and morphology is closely associated with flow velocity in patients with nonvalvular atrial fibrillation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Chen ◽  
Changjiang Xu ◽  
Wensu Chen ◽  
Chaoqun Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Mechanical Function ◽  
Orifice Area ◽  
The Relationship

Abstract Background Thromboembolic events are the most serious complication of atrial fibrillation (AF), and the left atrial appendage (LAA) is the most important site of thrombosis in patients with AF. During the period of COVID-19, a non-invasive left atrial appendage detection method is particularly important in order to reduce the exposure of the virus. This study used CT three-dimensional reconstruction methods to explore the relationship between LAA morphology, LAA orifice area and its mechanical function in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 81 consecutive patients with NVAF (36 cases of paroxysmal atrial fibrillation and 45 cases of persistent atrial fibrillation) who were planned to undergo catheter radiofrequency ablation were enrolled. All patients were examined by transthoracic echocardiography (TTE), TEE, and computed tomography angiography (CTA) before surgery. The LAA orifice area was obtained according to the images of CTA. According to the left atrial appendage morphology, it was divided into chicken wing type and non-chicken wing type. At the same time, TEE was performed to determine left atrial appendage flow velocity (LAAFV), and the relationship between the left atrial appendage orifice area and LAAFV was analyzed. Results The LAAFV in Non-chicken wing group was lower than that in Chicken wing group (36.2 ± 15.0 cm/s vs. 49.1 ± 22.0 cm/s, p-value < 0.05). In the subgroup analysis, the LAAFV in Non-chicken wing group was lower than that in Chicken wing group in the paroxysmal AF (44.0 ± 14.3 cm/s vs. 60.2 ± 22.8 cm/s, p-value < 0.05). In the persistent AF, similar results were observed (29.7 ± 12.4 cm/s vs. 40.8 ± 17.7 cm/s, p-value < 0.05). The LAAFV in persistent AF group was lower than that in paroxysmal AF group (34.6 ± 15.8 cm/s vs. 49.9 ± 20.0 cm/s, p-value < 0.001). The LAAFV was negatively correlated with left atrial dimension (R = − 0.451, p-value < 0.001), LAA orifice area (R= − 0.438, p-value < 0.001) and left ventricular mass index (LVMI) (R= − 0.624, p-value < 0.001), while it was positively correlated with LVEF (R = 0.271, p-value = 0.014). Multiple linear regression analysis showed that LAA morphology (β = − 0.335, p-value < 0.001), LAA orifice area (β = −  0.185, p-value = 0.033), AF type (β = − 0.167, p-value = 0.043) and LVMI (β = − 0.465, p-value < 0.001) were independent factors of LAAFV. Conclusions The LAA orifice area is closely related to the mechanical function of the LAA in patients with NVAF. The larger LAA orifice area and LVMI, Non-chicken wing LAA and persistent AF are independent predictors of decreased mechanical function of LAA, and these parameters might be helpful for better management of LA thrombosis.

Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population

2020 ◽  
Author(s):  
Koki Nakanishi ◽  
Masao Daimon ◽  
Yuriko Yoshida ◽  
Naoko Sawada ◽  
Kazutoshi Hirose ◽  
...  
Keyword(s):  
General Population ◽  
Subclinical Hypothyroidism ◽  
Left Atrial ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Left Heart ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Abstract Purpose Although subclinical hypothyroidism (SCH) is a common clinical entity and carries independent risk for incident heart failure (HF), its possible association with subclinical cardiac dysfunction is unclear. Left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic strain can unmask subclinical left heart abnormalities and are excellent predictors for HF. This study aimed to investigate the association between the presence of SCH and subclinical left heart dysfunction in a sample of the general population without overt cardiac disease. Methods We examined 1078 participants who voluntarily underwent extensive cardiovascular health check-ups, including laboratory tests and 2-dimensional speckle-tracking echocardiography to assess LVGLS and LA reservoir, conduit, and pump strain. SCH was defined as an elevated serum thyroid-stimulating hormone level with normal concentration of free thyroxine. Results Mean age was 62 ± 12 years, and 56% were men. Seventy-eight (7.2%) participants exhibited SCH. Individuals with SCH had significantly reduced LA reservoir (37.1 ± 6.6% vs 39.1 ± 6.6%; P = 0.011) and conduit strain (17.3 ± 6.3% vs 19.3 ± 6.6%; P = 0.012) compared with those with euthyroidism, whereas there was no significant difference in left ventricular ejection fraction, LA volume index, LVGLS, and LA pump strain between the 2 groups. In multivariable analyses, SCH remained associated with impaired LA reservoir strain, independent of age, traditional cardiovascular risk factors, and pertinent laboratory and echocardiographic parameters. including LVGLS (standardized β −0.054; P = 0.032). Conclusions In an unselected community-based cohort, individuals with SCH had significantly impaired LA phasic function. This association may be involved in the higher incidence of HF in subjects with SCH.

P4379Pathophysiology of left atrial filling in mitral regurgitation. A new volumetric flow rate index describing disturbed left atrial filling behavior in mitral regurgitation by 3D TTE

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Frumkin ◽  
K Stangl ◽  
A Muegge ◽  
T Buck ◽  
B Plicht
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrium ◽  
Flow Rate ◽  
Left Atrial ◽  
Volume Overload ◽  
Volumetric Flow Rate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Mean Flow ◽  
Flow Rates

Abstract Background In chronic mitral regurgitation (MR) the left atrium (LA) is one of the first cardiac structures involved in remodeling by progressive volume overload. Real-time three-dimensional echocardiography is able to monitor volumetric changes of the left atrium during the heart cycle. Purpose We hypothesized that chronic volume overload due to MR leads to detectable changes in the LA filling behavior described by mean and maximum filling flow rates and their relation called volumetric flow rate index. Methods We prospectively analyzed data of 36 patients in different stages of chronic MR and 13 patients without MR. Transthoracic echocardiography was conducted using the Epiq 7G Ultrasound System. Standard 2D- and 3D apical 4-chamber views were recorded and stored for offline analysis. We generated volume-time-curves by 3D volume analysis to derive mean and maximum volumetric flow rates during LA reservoir, conduit and pump phase. Volumetric flow rate index was calculated as the quotient of mean flow rate/maximum flow rate. Results Average MR severity, calculated with the MR Scoring system introduced from Buck et al. and implicated in the ESC Guidelines, was 6.2 points (±2.5) according to Grade I-II. We included 13 patients without MR, 18 with mild MR, 12 patients with moderate MR, 6 patients with severe MR. Left ventricular ejection fraction was similar in the different groups (51,2±12,3%). Maximum and mean flow rate showed no significant correlation with MR severity. Correlation of MR severity with LA dilation (ml/m2 BSA) was r=0.41; p<0.001. Flow rate index showed strong significant correlation with MR severity in left atrial reservoir phase (r=−0.75; p<0.001). There was no statistically relevant difference of volumetric flow rate parameters in left atrial pump and conduit phase. Line chart Conclusions We observed a significant correlation of the volumetric flow rate index to MR severity in the left atrial reservoir phase with stronger correlation than MR severity to left atrial dilation. The results of this work encourage further investigations to establish the presented volumetric flow rate index as a progression marker of MR and to evaluate its prognostic value.

Modification of lymph during passage through the lymph node: effect of histamine

1983 ◽  
Vol 245 (4) ◽  
pp. H553-H559
Author(s):  
M. B. Maron
Keyword(s):  
Lymph Node ◽  
Flow Rate ◽  
Evans Blue ◽  
Protein Concentration ◽  
Lymph Flow ◽  
Blue Dye ◽  
Base Line ◽  
Average Flow Rate ◽  
Significant Modification ◽  
Average Flow

The possibility that histamine may cause the fluid and protein content of lymph to be altered during passage through the lymph node was evaluated using the canine perfused popliteal lymph node preparation. This preparation enables nodal perfusion via an afferent lymphatic (all other afferents are ligated) with artificial lymph of known composition and collection of the total efferent effluent for analysis of potential changes in volume and composition. In 11 dogs, the node was perfused at an average flow rate of 0.229 ml/min with artificial lymph containing 3.71 g/100 ml albumin. Under base-line conditions, there was no significant modification of the lymph as it passed through the node. The addition of histamine to the infusate (2-4 micrograms base/ml) caused the efferent lymph flow to increase to 0.295 ml/min (35.3% increases, P less than 0.05), the efferent protein concentration to increase to 4.32 g/100 ml (15.2% increases, P less than 0.05), and the efferent protein flux to increase from 8.40 to 12.86 mg/min (58.0% increases, P less than 0.05). The appearance of Evans blue dye-tagged protein and plasma protein fractions, not originally present in the lymph, in the efferent lymph at this time further indicated that the source of the added fluid and protein was the nodal vasculature. Mass balance calculations indicated that the addition of a fluid with a protein concentration of approximately 90% that of plasma to the lymph could account for the observed increases in efferent lymph flow and protein concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals P1357 Left atrial function decreases with age in patients with repaired tetralogy of Fallot decrease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Y Hosono ◽  
K Takahashi ◽  
S Akimoto ◽  
M Ifuku ◽  
T Iso ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Atrial ◽  
Strain Analysis ◽  
Prognostic Indicator ◽  
Left Ventricular ◽  
Early Diastole ◽  
The Relationship ◽  
Normal Controls ◽  
Late Diastole

Abstract BACKGROUND Left ventricular function has been shown to be an important prognostic indicator in patients with repaired tetralogy of Fallot (rTOF) and tends to decrease with age. In recent years, left atrial (LA) function was reported to be a useful prognostic indicator more than or equal to left ventricular function in acquired heart diseases. However, atrial function in rTOF has not yet been sufficiently examined. PURPOSE The aim of this study was to investigate the relationship between LA dysfunction and age in rTOF using strain analysis. METHODS In order to assess the relationship between LA function and age, we recruited 59 patients with rTOF ranging in age from 5-40 years. We stratified the patients into 3 groups (T1: 5-10 years, T2: 11-20 years, T3: 21-40 years) and divided 54 controls of similar age into 3 corresponding groups (N1, N2, and N3). Two-dimensional speckle tracking images (2D-STI) obtained from four- and two-chamber views were used to assess LA functions by measuring reservoir, conduit, and pump strain. Additionally, we measured the strain rate (SR) in the systole, early diastole, and late diastole. RESULTS LA reservoir strain (37.4 ± 2.2% vs. 47.9 ± 1.7%, P= 0.004), LA pump strain (8.3 ± 1.4% vs. 14.1 ± 2.7%, p &lt;.001), atrial systolic LA-SR (1.5 ± 0.4% vs. 2.4 ± 0.6%, p &lt;.001), and systolic LA-SR (1.5 ± 0.3% vs. 2.1 ± 0.4%, p = 0.003) were significantly decreased in T3 compared with N3. Although only LA conduit strain decreased with aging (r = -0.3204, p = 0011) in controls, all of the LA reservoir (r = -0.325, p = 0.020), conduit (r = -0.314, p = 0.025), and pump strain (r = -0.481, p &lt; 0.001) in rTOF decreased with aging. Early diastole SR was significantly decreased in the T1 and T3 groups compared with the N1 and N3 groups (T1 vs N1, 3.00 ± 0.63% vs. 4.03 ± 0.0.80%, p &lt;.0.001, T3 vs N3, 2.31 ± 0.57% vs.3.31 ± 0.47%, p &lt; 0.001). Both systolic SR and late diastole SR decreased in T3 group compared with the N3 (1.54 ± 0.32% vs. 2.08 ± 0.42%, p = 0.003, 1.42 ± 0.32% vs.2.42 ± 0.61%, p &lt; 0.001), respectively. Although only early diastole SR decreased with aging (r = -0.415, p &lt; 0.001) in controls, all of the systole (r = -0.287, p = 0.041), early diastole (r = -0.337, p = 0.019), and late diastole SR (r = -0.407, p = 0.003) in rTOF decreased with aging. CONCLUSIONS In rTOF, most of the LA functions assessed by strain analysis decreased compared to normal controls in over 20 years old age. Furthermore, all measured functions decreased with age in rTOF while only two parameters decreased with age in normal controls. These results suggest that LA function may be an important indicator in long-term rTOF follow-up. These are new insights into LA function in patients with rTOF.

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