Functional and Anatomic Responses of the Left Atrium to Change in Estimated Left Ventricular Filling Pressure

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Quan L HuynhThomas H Marwick

Abstract

Left atrial (LA) remodeling and dysfunction reflect chronic exposure to elevated left ventricular (LV) filling pressures. The aim of this longitudinal cohort study was to define the effect of reducing LV filling pressures on reverse remodeling of LA volume (LAV) and function. This retrospective cohort included 195 patients (52% men; mean age, 64 ± 14 years) in sinus rhythm with LA dilatation and sequential echocardiograms (median interval, 1 year; interquartile range, 0.5-2.0 years). One hundred seventy-four patients underwent medical therapy (82 with reduced E/e' ratios), and 21 underwent surgery for valvular heart disease. Biplane LAV (normal value, ≤ 68 mL for men, ≤ 62 mL for women), LA strain (ε) (normal value, >32%) and LV filling pressures (assessed as E/e' ratio; normal value, <13) were measured. Although LAV at baseline and follow-up were 88 ± 27 and 81 ± 24 mL, LA ε and E/e' ratio remained stable at 26 ± 11% and 14 ± 7, respectively. Changes in E/e' ratio were associated with changes in LAV (r = 0.37, P < .001) and LA ε (r = -0.51 P < .001). Although reduced E/e' ratio or improved LA ε at follow-up occurred in about 50% of the patients, only 26% (51 of 195) had normalized LAV. Compared with surgery, successful reducti...Continue Reading

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Citations

Sep 18, 2016·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Marcelo Haertel MiglioranzaDenisa Muraru
Oct 13, 2017·Circulation. Cardiovascular Imaging·Erwan DonalFrederic Schnell
Mar 5, 2016·Circulation. Cardiovascular Imaging·Christine L Jellis, Allan L Klein
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Aug 24, 2021·European Heart Journal Cardiovascular Imaging·Alexander C EgbeHeidi M Connolly
Aug 26, 2021·European Heart Journal Cardiovascular Imaging·Elena GalliErwan Donal

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