الفهرس 
Left AtriumOnly 14 pages are availabe for public view
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Abstract
Summary
The left atrial (LA) pump function during the late left ventricular
(LV) diastole, that is, active LA emptying, plays an important role in
LV filling, especially in patients with hypertension or old
myocardial infarction. There are several noninvasive parameters that
can assess different properties of left atrium including Doppler
mitral inflow velocity-derived variables, and tissue Doppler imaging
(TDI). However, many of these parameters are influenced by
physiologic factors, particularly by alternations in preload. TDI has
emerged as a technique that is less affected by loading conditions
and provides a strong complementary role in the assessment of
diastolic function. Left atrial (LA) volume parameters are potentially
useful tools for assessing left atrial function but their roles need
further investigation.
The aim of this study was to investigate the role and limitations of
left atrial (LA) preload volume versus contractility as determinants
of active LA emptying in patients with heart failure.
We studied 50 healthy individuals (controls) and 50 patients with
heart failure (NYHA class II or III), the indexed Biplane LA volume
before atrial contraction (LAVpreI), Biplane post atrial contraction
volume index (LAVpostI), the biplane LA volume reduction index
(LASVI) during electrocardiography by using biplane modified
Simpson’s method to the left atrium. The transmitral peak flow
velocities during early diastole (E) and atrial contraction (A) were
determined using two dimensional pulsed Doppler
echocardiography. LA wall contraction velocity (LAWV) during
atrial contraction measured by tissue Doppler echocardiography by
on line analysis.
Summary
٩٢
There was excellent positive correlation between BP LAVpreI and
BP LASVI in patients (p-value<0.001) (r =+ 0.77)
Multivariate regression analysis showed that LAVpreI was the
most important factor that affecting LASVI.
Our results were in agreement with Hsiao SH, et al.2012, Hsiao SH,
et al.2011.
We concluded that in patients with impaired systolic function LA
dilation by the increased preload may enhance active LA emptying
rather than LA contractility.
We recommend routine echocardiographic Doppler evaluation of LA
volume and systolic function in all patients with HF for the purpose of risk
stratification