The alterations of left atrial functional parameters in high left atrial volume index and diastolic dysfunction

Yıl 2021, Cilt: 14 Sayı: 3, 612 - 619, 01.07.2021

Mehmet Furkan Özen , Sara Çetin Şanlıalp , Hande Şenol , Asuman Kaftan

https://doi.org/10.31362/patd.818185

Öz

Purpose: Previous studies have shown the relationship between left ventricular diastolic dysfunction (DD) and left atrial volume index (LAVi). However, limited studies have been reported have been reported on the relationship of functional parameters of left atrium (LA) with LAVi and DD. Therefore, we aimed to examine the changes of functional parameters of LA in high LAVi and DD in this study.
Materials and methods: Transthoracic echocardiography was performed in 81 healty subjects (LAVi<30 ml/m2) and 81 patients with DD (LAVi>30 ml/m²). Maximum, minimum and preatrial volumes were measured using area-length method. The functional parameters of LA and other parameters including miyocardial performance index (MPI), left ventricular mass index, relative wall thickness, max LAVi/A’, LA sphericity index, the total atrial conduction time (PA-TDI) were calculated and DD was determined by using transmitral and pulmoner ven inflow, pulsed wave Doppler and tissue Doppler.
Results: Initially; max LAVi, min LAVi, preA LAVi, max LAVi/A’, LA sphericity index, LA total emptying volume (EV) index, LA active EV index, LA passive EV index, PA-TDI, left ventricular relative wall thickness, left ventricular mass index and MPI were significantly higher in patients with DD and high LAVi (p<0.05). The groups had similar total LA emptying fraction (LAEF) when age difference was removed with Ancova test analysis. LA expansion index decreased with age in patients with DD and high LAVi in correlation analysis (r=-0.408, p<0.001).
Conclusion: Max LAVi, min LAVi, preA LAVi, max LAVi/A’, LA sphericity index, LA total EV index, LA active EV index, LA passive EV index, PA-TDI, relative wall thickness, left ventricular mass index and MPI were higher in DD and high LAVi regardless of age. Although LA expansion index and total LAEF did not show significant alterations until 57 years in healthy subjects in this study, both of them may decrease in patients with DD and high LAVi, especially in advanced ages, due to prolonged exposure to high filling pressure of left ventricle.

Anahtar Kelimeler

Diastolic dysfunction, echocardiography, functional parameters, left atrial volume index

Yüksek sol atriyal hacim indeksi ve diyastolik disfonksiyonunda sol atriyum fonksiyonel parametrelerindeki değişiklikler

Öz

Amaç: Önceki çalışmalar, sol ventrikül diyastolik disfonksiyon (DD) ile sol atriyal hacim indeksi (LAVi) arasındaki ilişkiyi göstermiştir. Bununla birlikte, sol atriyumun (LA) fonksiyonel parametrelerinin LAVi ve DD ile ilişkisi hakkında sınırlı sayıda çalışma bildirilmiştir. Bu nedenle, biz bu çalışmada yüksek LAVi ve DD'deki LA'nin fonksiyonel parametrelerindeki değişiklikleri incelemeyi amaçladık.
Gereç ve yöntem: 81 sağlıklı kişiye (LAVi <30 ml/m2) ve diyastolik disfonksiyonu olan 81 hastaya (LAVi>30 ml/m²) transtorasik ekokardiyografi yapıldı. Maksimum, minimum ve preatriyal hacimler alan-uzunluk yöntemi kullanılarak ölçüldü. LA'nin fonksiyonel parametreleri ve miyokardiyal performans indeksi (MPI), sol ventrikül kitle indeksi, rölatif duvar kalınlığı, maks LAVi / A', LA sferisite indeksi, toplam atriyal iletim süresi (PA-TDI) gibi diğer parametreler hesaplandı ve DD transmitral giriş, pulmoner ven girişi, pulse dalga (PW) Doppler ve doku Doppler (TDI) kullanılarak belirlendi.
Bulgular: Başlangıçta; maks LAVi, min LAVi, preA LAVi, maks LAVi/A ', LA sferisite indeksi, LA total boşalma hacmi (EV) indeksi, LA aktif EV indeksi, LA pasif EV indeksi, PA-TDI, sol ventriküler rölatif duvar kalınlığı, sol ventriküler kitle indeksi ve MPI, DD ve yüksek LAVi'li hastalarda anlamlı olarak daha yüksekti (p<0,05). Yaş farkı Ancova test analizi ile kaldırıldığında gruplar benzer toplam LAEF değerine sahipti. Korelasyon analizinde DD ve yüksek LAVi’si olan hastalarda LA genişleme indeksi yaşla birlikte azaldı (r=-0,408, p<0,001).

Sonuç: Maks LAVi, min LAVi, preA LAVi, maks LAVi/A ', LA sferisite indeksi, LA toplam EV indeksi, LA aktif EV indeksi, LA pasif EV indeksi, PA-TDI, rölatif duvar kalınlığı, sol ventriküler kitle indeksi ve MPI yaşa bakılmaksızın DD ve yüksek LAVi’si olan hastalarda daha yüksekti. Bu çalışmada sağlıklı kişilerde LA genişleme indeksi ve toplam LAEF, 57 yaşına kadar anlamlı değişiklikler göstermemekle birlikte her ikisi de DD'li ve yüksek LAVi'li hastalarda, özellikle ileri yaşlarda uzamış sol ventrikül yüksek dolum basıncına uzun süre maruz kalması nedeniyle azalabilir.

Anahtar Kelimeler

Diyastolik disfonksiyon, ekokardiyografi, fonksiyonel parametreler, sol atriyal hacim indeksi

Kaynakça

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