The left atrial volume curve can be assessed from pulmonary vein and mitral valve velocity tracings
Autor: | Piero Zardini, Isabella Loschiavo, Paolo Marino, Giorgio Golia, Antonia Prioli, Gianni Destro |
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Rok vydání: | 1994 |
Předmět: |
Adult
Cardiomyopathy Dilated Male medicine.medical_specialty Heart disease Adolescent Cardiac Volume Diastole Myocardial Ischemia Hemodynamics Pulmonary vein Internal medicine Mitral valve medicine Humans cardiovascular diseases Heart Atria Child Aged business.industry Blood flow Volume Curve Middle Aged medicine.disease Atrial Function Echocardiography Doppler Radiography medicine.anatomical_structure Ventricle Pulmonary Veins Case-Control Studies Child Preschool cardiovascular system Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
Zdroj: | American heart journal. 127(4 Pt 1) |
ISSN: | 0002-8703 |
Popis: | After instantaneous left atrial volume was defined as the net difference between the forward-flowing blood from the lungs and the blood flowing through the mitral valve, we constructed the left atrial volume curve by sampling the Doppler mitral valve and the right upper pulmonary vein velocity from an apical four-chamber view in eight normal subjects and 11 patients with heart disease. The instantaneous mitral valve flow was estimated as mitral valve velocity x annular area (derived from the same view), whereas the pulmonary venous flow was obtained as right upper pulmonary vein velocity x pulmonary vein area, where pulmonary vein area = mitral valve velocity integral x mitral valve area) divided by pulmonary vein velocity integral. The left atrial volume curve can then be derived as: [(instantaneous pulmonary venous flow - mitral valve flow) + left atrial volume assessed at end diastole by two-dimensional echocardiography]. Biplane angiographic left atrial volume curves, available in four of 11 patients, compared morphologically very closely with the noninvasive curves, whereas the correlation coefficient for maximum (end-systolic) and filling (maximum minus minimum) left atrial volumes obtained from the Doppler-derived curve and the corresponding two-dimensional echocardiographic estimates was 0.95 (p0.001, standard error of the estimate = 11.9 ml), the dispersion of the data increased with decreasing volumes. These data demonstrate that combined Doppler mitral valve and pulmonary vein velocities can be used to construct the left atrial volume curve in human beings. The approach described, besides providing a tool for further noninvasive evaluation of the left atrial function, offers the opportunity for relating the continuous pulmonary venous flow to the intermittent filling of the ventricle through the mitral orifice in diastole, underlining the complex role that the left atrial cavity plays in this process. |
Databáze: | OpenAIRE |
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