Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography.

Autor: Olsen FJ; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. flemming.j.olsen@gmail.com.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. flemming.j.olsen@gmail.com.; Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, 2900, Hellerup, Denmark. flemming.j.olsen@gmail.com., Møgelvang R; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Southern Denmark, Svendborg, Denmark.; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., de Knegt MC; Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Galatius S; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark., Pedersen S; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark., Modin D; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark., Ravnkilde K; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark., Gislason G; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Biering-Sørensen T; Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2021 Nov; Vol. 37 (11), pp. 3213-3221. Date of Electronic Publication: 2021 May 29.
DOI: 10.1007/s10554-021-02300-5
Abstrakt: Echocardiography guidelines recommend the assessment of maximal LA volume (LAV max ). Evidence, however, suggests additional value of functional LA measures. We investigated the association between functional LA measures and left ventricular end-diastolic pressure (LVEDP). Patients suspected of coronary artery disease referred for invasive coronary angiography (ICA) underwent, in addition to ICA, invasive pressure measurements. LVEDP > 12 mmHg was considered elevated. LA measurements by echocardiography included: LAV max , minimal LA volume (LAV min ), total LA emptying fraction (LAEF total ), passive LA emptying fraction (LAEF passive ), and active LA emptying fraction (LAEF active ). Of 43 patients, 28 (65%) had elevated LVEDP. These patients more frequently had coronary vessel disease (VD) and impaired LA mechanics for all measures except LAV max . All LA measures except LAV max were associated with LVEDP in unadjusted linear regression analyses. After adjustment for age and VD, only LA emptying fractions remained associated with LVEDP (2.6 (1.2-4.0) mmHg increase, p = 0.001, per 5% decrease in LAEF total ; 1.4 (0.1-2.8) mmHg increase, p = 0.040, per 5% decrease in LAEF active ; 1.8 (0.1-3.4) mmHg increase, p = 0.038, per 5% decrease in LAEF passive ). In logistic regression, only LAEF passive was significantly associated with elevated LVEDP after adjusting for age and VD (OR = 1.11 (1.01-1.21), p = 0.023, per 1% decrease). Similar findings were made in subgroup analyses among patients without dilated LA and patients without conventional indicators of elevated filling pressure. Left ventricular end-diastolic pressure is significantly associated with LA functional measures but not LA volumes. Additionally, LAEF passive is associated with elevated LVEDP. Future studies examining LA function should include all components of LAEF.
(© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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