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

Abstract

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 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.