Postnatal Development of a Left-Right Atrial Pressure Gradient

1956 ◽  
Vol 186 (3) ◽  
pp. 521-524 ◽  
Author(s):  
A. van Harreveld ◽  
F. E. Russell
Keyword(s):  
Left Ventricle ◽  
Pressure Gradient ◽  
Left Atrium ◽  
Postnatal Development ◽  
Right Atrial ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Equal Thickness

The mean left and right atrial pressures were measured in six groups of 10 kittens each. One group was examined between the 12th and 24th hour after birth, one group after 3 days, after 1 week, 2 weeks, 1 month and 2 months. The left and right atrial pressures were almost equal in the first group. With age an increasing left to right pressure gradient developed. In the oldest group the pressure in the left atrium was almost twice as great as in the right. Parallel with the pressure gradient a difference developed in the wall thicknesses of the left and right ventricles. At birth the ventricular walls were of about equal thickness; at age 2 months the left ventricle wall was more than twice as thick as the right. The relationship between ventricle wall thicknesses and atrial pressures is discussed.

scholarly journals Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248951
Author(s):  
Gurpreet Singh Dhillon ◽  
Nikhil Ahluwalia ◽  
Shohreh Honarbakhsh ◽  
Adam Graham ◽  
Antonio Creta ◽  
...  
Keyword(s):  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Right Atrial ◽  
Mapping Data ◽  
Refractory Periods ◽  
Non Invasive ◽  
Significant Difference ◽  
Left And Right ◽  
The Right ◽  
Number Of Segments

Background We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. Methods Persistent AF patients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and right atrial appendages and repeated following boluses of 18 mg of intravenous adenosine. Potential drivers (PDs) were defined as focal or rotational activations completing ≥ 1.5 revolutions. Distribution of PDs was assessed using an 18 segment biatrial model. Results 46 patients were enrolled. Mean age was 63.4 ± 9.8 years with 33 (72%) being male. There was no significant difference in the number of PDs recorded at baseline compared to adenosine (42.1 ± 15.2 vs 40.4 ± 13.0; p = 0.417), nor in the number of segments harbouring PDs, (13 (11–14) vs 12 (10–14); p = 0.169). There was a significantly higher percentage of PDs that were focal in the adenosine maps (36.2 ± 15.2 vs 32.2 ± 14.4; p < 0.001). There was a significant shortening of CL in the adenosine maps compared to baseline which was more marked in the right atrium than left atrium (176.7 ± 34.7 vs 149.9 ± 27.7 ms; p < 0.001 and 165.6 ± 31.7 vs 148.3 ± 28.4 ms; p = 0.003). Conclusion Adenosine led to a small but significant shortening of CL which was more marked in the right than left atrium and may relate to shortening of refractory periods rather than an increase in driver burden or distribution. Registered on Clinicaltrials.gov: NCT03394404.

Effects of hyperthyroidism on delayed rectifier K+ currents in left and right murine atria

2005 ◽  
Vol 289 (4) ◽  
pp. H1448-H1455 ◽  
Author(s):  
Ying Hu ◽  
S. V. Penelope Jones ◽  
Wolfgang H. Dillmann
Keyword(s):  
Protein Expression ◽  
Left Atrium ◽  
Right Atrial ◽  
Delayed Rectifier ◽  
Rnase Protection ◽  
Expression Levels ◽  
Mrna And Protein Expression ◽  
Left And Right ◽  
The Right ◽  
Right Atria

Hyperthyroidism has been associated with atrial fibrillation (AF); however, hyperthyroidism-induced ion channel changes that may predispose to AF have not been fully elucidated. To understand the electrophysiological changes that occur in left and right atria with hyperthyroidism, the patch-clamp technique was used to compare action potential duration (APD) and whole cell currents in myocytes from left and right atria from both control and hyperthyroid mice. Additionally, RNase protection assays and immunoblotting were performed to evaluate the mRNA and protein expression levels of K+ channel α-subunits in left and right atria. The results showed that 1) in control mice, the APD was shorter and the ultra-rapid delayed rectifier K+ conductance ( IKur) and the sustained delayed rectifier K+ conductance ( Iss) were larger in the left than in the right atrium; also, mRNA and protein expression levels of Kv1.5 and Kv2.1 were higher in the left atrium; 2) in hyperthyroid mice, the APD was shortened and IKur and Iss were increased in both left and right atrial myocytes, and the protein expression levels of Kv1.5 and Kv2.1 were increased significantly in both atria; and 3) the influence of hyperthyroidism on APD and delayed rectifier K+ currents was more prominent in right than in left atrium, which minimized the interatrial APD difference. In conclusion, hyperthyroidism resulted in more significant APD shortening and greater delayed rectifier K+ current increases in the right vs. the left atrium, which can contribute to the propensity for atrial arrhythmia in hyperthyroid heart.

659Left atrial wall thickness evaluation during atrial fibrillation redo procedures

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Teres ◽  
D Soto ◽  
B Jauregui ◽  
D Penela ◽  
A Ordonez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Wall Thickness ◽  
Atrial Wall ◽  
Ablation Procedure ◽  
Left Atrial Wall ◽  
Local Distance ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Dr Teres was funded by Swiss Heartrhythm Foundation Introduction pulmonary vein (PV) reconnections due to gaps on circumferential ablation lines are responsible for atrial fibrillation recurrences after catheter ablation. We sought to analyze the local left atrial wall thickness (LAWT) of PV line gaps at AF redo ablation during real-time catheter positioning. LAWT was measured on the MDCT 3D reconstruction and fused with the LA anatomy using CARTO-merge. Objective To analyze the relationship between local reconnection gaps and the LAWT during AF redo procedures. Methods Single-Center cohort study that included 41 consecutive patients referred for AF redo procedure. All patients had a MDCT prior to the ablation procedure. LAWT maps were semi-automatically computed from the MDCT as the local distance between the LA endo and epicardium. Each PV line was subdivided into 8 segments and mean LAWT was computed. During the procedure, the local gap was defined as the earliest activation site at the reconnected segment of the circumferential PV line (Figure 1A & 1B). Results 41 patients [31 (75.6%) male, age 60 ± 10 years] were included. Mean LAWT was 1.36 ± 0.20 mm. Mean PV circumferential line WT was higher in left PVs than in the right PVs 1.68 ± 0.57 vs. 1.31 ± 0.39 mm p &lt; 0.001 respectively. Mean WT of the reconnected points was 44% higher than the mean WT of the segment where the reconnection was located. Mean reconnection point WT was at the 87th percentile of the circumferential line in the LPVs and at the 76th percentile in the RPVs. The reconnected point WT was higher in the LPVs than RPVs 2.13 ± 1.14 vs. 1.47 ± 0.48 mm p &lt; 0.001 respectively.  The most frequent location for reconnections was the left anterior carina (71%), with a mean WT of 2.24 ± 0.91mm; and the right anterior carina (56%) with a mean WT of 1.57 ± 0.62mm (Figure 2A & 2B). Conclusions Reconnection points were more frequently present in the thicker segments of the PV circumferential line. The most frequently reconnected segment was the anterior carina in both right and left PVs. Atrial wall thickness maps derived from MDCT are useful to guide AF redo procedures. Abstract Figure. 1) Activation & WT map; 2) Segment WT

scholarly journals Cardiac involvement in patients with coronavirus pneumonia

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
O Germanova ◽  
O Tereshina
Keyword(s):  
Left Ventricle ◽  
Right Ventricle ◽  
Left Atrium ◽  
Longitudinal Strain ◽  
Cardiac Involvement ◽  
Mean Value ◽  
Systolic Pulmonary Artery Pressure ◽  
Functional Changes ◽  
End Diastolic Volume ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background. New COVID-19 disease is well known by its primary damage of respiratory system. However, it is also possible to involve other organs and systems. Purpose. To determine the cardiac involvement in patients with COVID-19 pneumonia. Materials and methods. We performed echocardiography with speckle tracking in 48 patients. All of them had serologically verified COVID-19 pneumonia with lung involvement 5-60% on CT. None of them were treated by antimalarial drugs. 28 of them were men and 20 women, mean age - 45 ± 4,4 years old. We performed echocardiography in 1 month period from onset of the disease. Results. Most of the patients (30 patients) had enlargement of right heart chambers. Despite of right ventricle enlargement, in none of the patients had reduced right ventricle function (TAPSE 22 ± 2 mm, right ventricle strain -21,2 ± 1,5%). The mean systolic pulmonary artery pressure was slightly elevated (38 ± 2 mm Hg). Left ventricle was enlarged in 9 patients (with mean end diastolic volume 82 ± 5 ml/m2). In 25 of them, the ejection fraction was decreased (44 ± 4%). In all patients with COVID-19 pneumonia, the changes in circumferential and longitudinal strain were observed. Both parameters were decreased. The mean value of circumferential strain was -16,3 ± 1,9%. The longitudinal strain parameter was -14,2 ± 1,4%. 25 patients had enlargement of left atrium (&gt;40ml/m2) and the reservoir strain of left atrium was decreased (-23,3 ± 1,5%)  in 29 of them. After 2 months from the onset of the disease, we noticed the normalization of echocardiography data in all patients. Nevertheless, we observed cardiac structural and functional changes in all patients, troponins levels were increased only in 12 patients. Conclusion. We observed cardiac involvement in different degree in all of patients with COVID-19 pneumonia. Changes characterized by atriums and ventricles enlargement, and left ventricle contractile dysfunction.  Due to the fact that only part of the patients with COVID-19 with cardiac changes had elevated troponins, we believe that the mechanism of these pathological changes need further research.

Association of epicardial fat thickness with left ventricular diastolic function parameters in a community population

2021 ◽  
Author(s):  
Wei Ma ◽  
Baowei Zhang ◽  
Ying Yang ◽  
Litong Qi ◽  
Jin Zhou ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Right Ventricular ◽  
Diastolic Function ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Community Population ◽  
The Mean ◽  
The Right ◽  
The Relationship

Abstract Purpose We examined the relationship between EFT measured by echocardiography and LV diastolic function parameters in a Beijing community population. Methods We included 1004 participants in this study. Echocardiographic parameters including E and A peak velocity, the early diastolic velocities (e’) of the septal and lateral of mitral annulus using tissue doppler imaging, E/e’, and EFT, were measured. EFT1 was measured perpendicularly on the right ventricular free wall at end-diastole in the extension line of the aortic root. EFT2 was the maximum thickness measured perpendicularly on the right ventricular free wall at end-diastole. Multivariate linear regression was used to analyze the relationship between EFT and the mean e’ and E/e’. Results The mean age of the participants was 63.91 ± 9.02 years old (51.4% men). EFT1 and EFT2 were negatively correlated with e’ lat, e’ sep, and e’ mean (p < 0.05), and positively correlated with E/e’ lat, E/e’ sep, and E/e’ mean. Multivariate regression analysis showed that EFT1 and EFT2 were independently and negatively correlated with e’ mean (EFT1: β = −0.089 [95% confidence interval = − 0.177, − 0.000, p = 0.050]; EFT2: β = −0.078 [95% confidence interval = − 0.143, − 0.012, p = 0.020]). There were no interactions between EFT and any covariates, including age or heart groups, sex, BMI, or presence of hypertension, diabetes, or coronary heart disease in relation to LV diastolic dysfunction. Conclusions EFT was negatively and independently correlated with e’ mean, suggesting that more attention to this type of adipose fat is required for cardiovascular disease therapy.

Cardiovascular Physical Examination

2016 ◽  
pp. 53-58
Author(s):  
Kyle W. Klarich ◽  
Lori A. Blauwet ◽  
Sabrina D. Phillips
Keyword(s):  
Physical Examination ◽  
Right Ventricle ◽  
Wave Amplitude ◽  
Venous Pressure ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Jugular Venous Pressure ◽  
Structural Disease ◽  
The Right ◽  
The Relationship

Jugular venous pressure reflects right atrial pressure and the relationship between right atrial filling and emptying into the right ventricle. Changes in wave amplitude may indicate structural disease and rhythm changes. Normal jugular venous pressure is 6 to 8 cm H2O. It is best evaluated with the patient supine at an angle of at least 45°. The right atrium lies 5 cm below the sternal angle, and thus the estimated jugular venous pressure equals the height of the jugular venous pressure above the sternal angle + 5 cm.

Baroreflex modulation of heart rate and initiation of atrial activation in dogs

1988 ◽  
Vol 255 (3) ◽  
pp. H503-H513 ◽  
Author(s):  
R. B. Schuessler ◽  
T. E. Canavan ◽  
J. P. Boineau ◽  
J. L. Cox
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Right Atrial ◽  
Autonomic Blockade ◽  
Left And Right ◽  
Atrial Activation ◽  
The Right ◽  
A Site ◽  
Induced Changes ◽  
Cardiac Nerves

In open-chest dogs, blood pressure was regulated by titrating doses of phenylephrine and nitroprusside to determine its effect on heart rate and pacemaker location. Changes in blood pressure correlated with changes in heart rate (r = 0.86). Activation time mapping demonstrated multicentric atrial activation, with a site of origin-rate relationship. The fastest pacemakers were located in the most cranial regions and slowest in the most caudal areas. In this chloralose-morphine anesthetized model, autonomic blockade with atropine and propranolol suggests that acute baroreflex-induced changes in heart rate were mediated exclusively by either increased sympathetic or parasympathetic tone and were not associated with inhibition of the opposite system. Division of right and left thoracic cardiac nerves indicated the left sympathetics participated in the baroreflex in 50% of the animals and the left parasympathetics in 90% of the animals. Both the right sympathetics and parasympathetics were active in the baroreflex in all animals. The data demonstrate that physiological heart rate response is regulated through an extensive system of right atrial pacemakers modulated by both left and right efferent cardiac nerves.

Cat heart acetylcholine: structural proof and distribution

1976 ◽  
Vol 231 (3) ◽  
pp. 781-785 ◽  
Author(s):  
OM Brown
Keyword(s):  
Left Ventricle ◽  
Right Ventricle ◽  
Left Atrium ◽  
Right Atrium ◽  
Interventricular Septum ◽  
Pyrolysis Product ◽  
Heart Tissue ◽  
Choline Esters ◽  
The Right ◽  
Cat Heart

The distribution of acetylcholine (ACh) in the cat heart was investigated by a pyrolysis-gas chromatography (PGC) method. The hearts were dissected into various regions and homogenized in acetonitrile in the presence of propionylcholine, internal standard. Following extraction with toluene and hexane, the choline esters were precipitated as the enneaiodide complex. The isolated choline esters were analyzed by PGC, and the peak corresponding to ACh was quantified. The compound extracted from heart tissue that eluted with the retention time of authentic ACh was identified by mass spectrometry as dimethylaminoethylacetate, the pyrolysis product of ACh. ACh concentrations were found to be higher in the atria than the ventricles. In both the atria and the ventricles, a higher content of ACh was found in the right than the left portions: right ventricle, 5.0 compared to left ventricle, 2.0 nmol/g; and right atrium, 16.8 compared to left atrium, 11.3 nmol/g. Some cats were subjected to a bilateral cervical vagotomy 3 wk before removal and analysis of heart tissue. Hearts from vagotomized cats contained less ACh than controls in the right ventricle (-31%), right atrium (-54%), SA node (-42%), and papillary muscle (-53%), but no decreases were found in the left ventricle, left atrium, or interventricular septum.

scholarly journals Noninvasive evaluation of pulmonary artery pressure during exercise: the importance of right atrial hypertension

2019 ◽  
Vol 55 (2) ◽  
pp. 1901617 ◽  
Author(s):  
Masaru Obokata ◽  
Garvan C. Kane ◽  
Hidemi Sorimachi ◽  
Yogesh N.V. Reddy ◽  
Thomas P. Olson ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pressure Gradient ◽  
Systolic Pressure ◽  
Area Under The Curve ◽  
Right Atrial ◽  
Pulmonary Artery Systolic Pressure ◽  
Therapeutic Implications ◽  
Exercise Induced ◽  
The Right ◽  
Minimal Bias

IntroductionIdentification of elevated pulmonary artery pressures during exercise has important diagnostic, prognostic and therapeutic implications. Stress echocardiography is frequently used to estimate pulmonary artery pressures during exercise testing, but data supporting this practice are limited. This study examined the accuracy of Doppler echocardiography for the estimation of pulmonary artery pressures at rest and during exercise.MethodsSimultaneous cardiac catheterisation-echocardiographic studies were performed at rest and during exercise in 97 subjects with dyspnoea. Echocardiography-estimated pulmonary artery systolic pressure (ePASP) was calculated from the right ventricular (RV) to right atrial (RA) pressure gradient and estimated RA pressure (eRAP), and then compared with directly measured PASP and RAP.ResultsEstimated PASP was obtainable in 57% of subjects at rest, but feasibility decreased to 15–16% during exercise, due mainly to an inability to obtain eRAP during stress. Estimated PASP correlated well with direct PASP at rest (r=0.76, p<0.0001; bias −1 mmHg) and during exercise (r=0.76, p=0.001; bias +3 mmHg). When assuming eRAP of 10 mmHg, ePASP correlated with direct PASP (r=0.70, p<0.0001), but substantially underestimated true values (bias +9 mmHg), with the greatest underestimation among patients with severe exercise-induced pulmonary hypertension (EIPH). Estimation of eRAP during exercise from resting eRAP improved discrimination of patients with or without EIPH (area under the curve 0.81), with minimal bias (5 mmHg), but wide limits of agreement (−14–25 mmHg).ConclusionsThe RV–RA pressure gradient can be estimated with reasonable accuracy during exercise when measurable. However, RA hypertension frequently develops in patients with EIPH, and the inability to noninvasively account for this leads to substantial underestimation of exercise pulmonary artery pressures.

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