J Cardiovasc Ultrasound.  2012 Mar;20(1):25-29. 10.4250/jcu.2012.20.1.25.

Left Atrial Volume Index as Indicator of Left Ventricular Diastolic Dysfunction: Comparation between Left Atrial Volume Index and Tissue Myocardial Performance Index

• Cacciapuoti F
• Scognamiglio A
• Paoli VD
• Romano C
• Cacciapuoti F

• KMID: 2177337
• DOI: http://doi.org/10.4250/jcu.2012.20.1.25

Abstract

BACKGROUND
To point out a possible correlation between left atrial volume index (LAVI) and left ventricular (LV) diastolic time interval to better define LV diastolic dysfunction, this study was performed.
METHODS
In 62 hypertensive-hypertrophic patients without LV systolic dysfunction, LV volumes, myocardial mass index, ejection fraction% (EF%) and LAVI were measured by two-dimensional echocardiography. Instead, tissue Doppler echocardiography (TDE) was used to measure myocardial performance index (MPI) and its systo-diastolic time intervals, such as: iso-volumetric contraction time (IVCT); iso-volumetric relaxation time (IVRT); ejection time. LAVI, TDE-MPI and time intervals where also measured in 15 healthy controls, to obtain the reference values.
RESULTS
Results shown a significant increase of LV volumes in hypertensives in comparison to the control group (p < 0.05). LV mass index also augmented (p < 0.001). Instead, EF% not significantly changed in hypertrophic patients in comparison with healthy controls. LAVI raised in hypertensives wih left ventricular hypertrophy, whereas IVCT resulted within the normal limits. On the contrary, IVRT significantly raised. Accordingly, MPI resulted higher in controls.
CONCLUSION
LAVI, MPI and its time intervals appear as reliable tools to non-invasively individualize LV diastolic dysfunction in systemic hypertension, in absence of mitral valve disease.

Keyword

Left atrial volume index; Left ventricular hypertrophy; Myocardial performance index; LV diastolic dysfunction; Ejection fraction%

MeSH Terms

Contracts
Echocardiography
Echocardiography, Doppler
Humans
Hypertension
Hypertrophy, Left Ventricular
Mitral Valve
Relaxation

Reference

1. Appleton CP, Galloway JM, Gonzalez MS, Gaballa M, Basnight MA. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. J Am Coll Cardiol. 1993. 22:1972–1982.

2. Simek CL, Feldman MD, Haber HL, Wu CC, Jayaweera AR, Kaul S. Relationship between left ventricular wall thickness and left atrial size: comparison with other measures of diastolic function. J Am Soc Echocardiogr. 1995. 8:37–47.

3. Schabelman S, Schiller NB, Silverman NH, Ports TA. Left atrial volume estimation by two-dimensional echocardiography. Cathet Cardiovasc Diagn. 1981. 7:165–178.

4. Schiller NB, Botvinick EH. Noninvasive quantitation of the left heart by echocardiography and scintigraphy. Cardiovasc Clin. 1986. 17:45–93.

5. Moller JE, Hillis GS, Oh JK, Seward JB, Reeder GS, Wright RS, Park SW, Bailey KR, Pellikka PA. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003. 107:2207–2212.

6. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol. 1995. 26:357–366.

7. Tei C, Dujardin KS, Hodge DO, Kyle RA, Tajik AJ, Seward JB. Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol. 1996. 28:658–664.

8. Isaaz K. Tissue Doppler imaging for the assessment of left ventricular systolic and diastolic functions. Curr Opin Cardiol. 2002. 17:431–442.

9. Tekten T, Onbasili AO, Ceyhan C, Unal S, Discigil B. Value of measuring myocardial performance index by tissue Doppler echocardiography in normal and diseased heart. Jpn Heart J. 2003. 44:403–416.

10. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986. 57:450–458.

11. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelista A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009. 22:107–133.

12. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Chamber Quantification Writing Group. American Society of Echocardiography's Guidelines and Standards Committee. European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005. 18:1440–1463.

13. Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989. 2:358–367.

14. Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006. 47:2357–2363.

15. Galiuto L, Ignone G, DeMaria AN. Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol. 1998. 81:609–614.

16. Jiamsripong P, Honda T, Reuss CS, Hurst RT, Chaliki HP, Grill DE, Schneck SL, Tyler R, Khandheria BK, Lester SJ. Three methods for evaluation of left atrial volume. Eur J Echocardiogr. 2008. 9:351–355.

17. Ujino K, Barnes ME, Cha SS, Langins AP, Bailey KR, Seward JB, Tsang TS. Two-dimensional echocardiographic methods for assessment of left atrial volume. Am J Cardiol. 2006. 98:1185–1188.

18. Pritchett AM, Jacobsen SJ, Mahoney DW, Rodeheffer RJ, Bailey KR, Redfield MM. Left atrial volume as an index of left atrial size: a population-based study. J Am Coll Cardiol. 2003. 41:1036–1043.

19. Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002. 90:1284–1289.

20. Vandenberg BF, Weiss RM, Kinzey J, Acker M, Stark CA, Stanford W, Burns TL, Marcus ML, Kerber RE. Comparison of left atrial volume by two-dimensional echocardiography and cine-computed tomography. Am J Cardiol. 1995. 75:754–757.

21. Patel VV, Ren JF, Jeffery ME, Plappert TJ, St John Sutton MG, Marchlinski FE. Comparison of left atrial volume assessed by magnetic endocardial catheter mapping versus transthoracic echocardiography. Am J Cardiol. 2003. 91:351–354.

22. Prioli A, Marino P, Lanzoni L, Zardini P. Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol. 1998. 82:756–761.

23. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol. 2003. 42:1206–1207.

24. Teo SG, Yang H, Chai P, Yeo TC. Impact of left ventricular diastolic dysfunction on left atrial volume and function: a volumetric analysis. Eur J Echocardiogr. 2010. 11:38–43.

25. Leung DY, Boyd A, Ng AA, Chi C, Thomas L. Echocardiographic evaluation of left atrial size and function: current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J. 2008. 156:1056–1064.

26. Waggoner AD, Bierig SM. Tissue Doppler imaging: a useful echocardiographic method for the cardiac sonographer to assess systolic and diastolic Tei C. New non-invasive index for combined systolic and diastolic ventricular function. J Am Soc Echocardiogr. 2001. 14:1143–1152.

27. Tei C. New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol. 1995. 26:135–136.

28. Bruch C, Schmermund A, Marin D, Katz M, Bartel T, Schaar J, Erbel R. Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J. 2000. 21:1888–1895.

29. Poulsen SH, Nielsen JC, Andersen HR. The influence of heart rate on the Doppler-derived myocardial performance index. J Am Soc Echocardiogr. 2000. 13:379–384.

30. Nearchou NS, Tsakiris AK, Tsitsirikos MD, Karatzis EN, Lolaka MD, Flessa KD, Bogiatzis DT, Skoufas PD. Tei index as a method of evaluating left ventricular diastolic dysfunction in acute myocardial infarction. Hellenic J Cardiol. 2005. 46:35–42.

31. Vaziri SM, Larson MG, Lauer MS, Benjamin EJ, Levy D. Influence of blood pressure on left atrial size. The Framingham Heart Study. Hypertension. 1995. 25:1155–1160.

32. Pritchett AM, Mahoney DW, Jacobsen SJ, Rodeheffer RJ, Karon BL, Redfield MM. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol. 2005. 45:87–92.

33. Leung DY, Chi C, Allman C, Boyd A, Ng AC, Kadappu KK, Leung M, Thomas L. Prognostic implications of left atrial volume index in patients in sinus rhythm. Am J Cardiol. 2010. 105:1635–1639.