Atrial ejection force: A noninvasive assessment of atrial systolic function

Manning, Warren J.; Katz, Sidney; Douglas, Pamela S.; Silverman, David I.

doi:10.1016/0735-1097(93)90838-r

Cited by 207 publications

(163 citation statements)

References 21 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…Representa a força exercida pelo AE para aceleração do sangue para o VE durante a sístole atrial aplicando os princípios da segunda lei de movimento de Newton, e representa uma alternativa para avaliação não invasiva da função sistólica atrial, combinando dados do ecocardiograma bidimensional e onda A do fluxo mitral 45 . Apesar de atraente, sua utilidade tem sido questionada devido à influência das condições de carga, idade, e ainda não ter a reprodutibilidade documentada 27,46 .…”

Section: Outras Formas De Avaliação Da Função Atrial Esquerda Força Dunclassified

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Matsumoto¹,

Mancuso²,

Tatani³

et al. 2014

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

View full text Add to dashboard Cite

ResumoA avaliação da função atrial esquerda pode proporcionar informações importantes relacionadas à fisiopatologia de muitas cardiopatias, principalmente quando o envolvimento é das cavidades esquerdas. Entretanto, ao contrário das funções sistólica e diastólica do ventrículo esquerdo, amplamente exploradas em muitas condições clínicas, a função do átrio esquerdo é, ainda, pouco estudada.Conceitos básicos das funções de reservatório, de conduto e de bomba do átrio esquerdo são discutidos, destacando as relações com enchimento ventricular. Métodos de investigação dessas funções são apresentados de forma resumida. IntroduçãoAo contrário das funções sistólica e diastólica do Ventrículo Esquerdo (VE), amplamente analisadas em várias condições clínicas e experimentais, a função do Átrio Esquerdo (AE) tem sido pouco estudada, apesar de sua reconhecida importância no desempenho global do VE 1 .A análise da função atrial esquerda, associada ao estudo da diástole ventricular esquerda, pode acrescentar informações fundamentais para a compreensão dos mecanismos fisiológicos e fisiopatológicos envolvidos em diversas condições cardiovasculares.Com a abertura da valva mitral, AE e VE atuam praticamente como uma cavidade única e, portanto, com influência mútua no enchimento e esvaziamento dessas cavidades 2 .Vários fatores contribuíram para o ressurgimento do interesse no estudo da função atrial esquerda. Destacam-se: 1) ampla utilização de procedimentos envolvendo diretamente o AE, tais como intervenções medicamentosas, dispositivos eletrônicos, radioablação e cirurgias utilizadas no tratamento da fibrilação atrial [3][4][5] ; 2) reconhecimento de remodelamento elétrico, iônico e mecânico do AE 5 ; 3) fenômeno do "stunning" pós-cardioversão 6,7 ; e 4) importância prognóstica do tamanho e função atrial esquerda na insuficiência cardíaca [8][9][10] . Com a ecocardiografia, muitas informações das dimensões e da função atrial podem ser obtidas, utilizando técnicas e métodos mais recentemente validados, de forma simples e consistente 11 . Esta revisão tem como objetivo a abordagem de aspectos importantes da fisiologia do AE, que poderão auxiliar na interpretação de mecanismos en-volvidos na diástole do VE, em condições normais e de doenças. FisiologiaUma das funções do AE é proporcionar aporte sanguíneo para a diástole ventricular.Nesse processo estão envolvidos o relaxamento, a complacência e outras características funcionais do AE, e também as funções sistólica e diastólica do VE. Essas particularidades devem ser analisadas de forma integrada, pois são interdependentes e, portanto, indissociáveis. Entretanto, para fins didáticos, os conceitos serão comentados de forma separada.O AE exerce ação reguladora no enchimento ventricular por meio de três funções básicas: 1) de reservatório, durante a diástole atrial; 2) de conduto, durante o esvaziamento passivo no período de relaxamento ventricular e diástase; 3) de bomba propulsora na fase de contração, ou esvaziamento ativo, desde que em ritmo sinusal, o que contribui de forma signi...

show abstract

Section: Outras Formas De Avaliação Da Função Atrial Esquerda Força Dunclassified

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Matsumoto¹,

Mancuso²,

Tatani³

et al. 2014

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

View full text Add to dashboard Cite

show abstract

“…The unit force was measured in dynes. 10 In a previous study the normal range of AEF in healthy subjects of different age decades was assessed. 11 All measurements were taken during quiet breathing, with patients in the left lateral decubitus position.…”

Section: Echocardiographymentioning

confidence: 99%

“…According to Manning and colleagues, 10 the equation used for calculation was AEF = 0.5 × ρ × mitral orifice area × (peak A velocity) 2 where ρ is the density of blood (1.06 g/cm 3 ). The unit force was measured in dynes.…”

Section: Echocardiographymentioning

confidence: 99%

“…They observed that the strength of atrial contraction was reduced in the early postcardioversion period and progressively increased. 10 The AEF provides a physiologic assessment of atrial systolic function because it includes both the acceleration of blood ejected by the atrium and the mass of blood ejected through the mitral valve. The normal value of AEF varies by age according to peak A wave velocity variation.…”

Section: Evaluation Of Atrial Function Using Aefmentioning

confidence: 99%

See 1 more Smart Citation

Doppler sonographic evaluation of left atrial function after cardioversion of atrial fibrillation.

Mattioli

Castelli²,

Sternieri³

et al. 1999

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

Restoration of sinus rhythm is not always followed by immediate return of effective atrial contraction. Left atrial mechanical function can be assessed by Doppler echocardiography; in the present study we measured the atrial ejection force, which is a noninvasive Doppler‐derived parameter that measures the strength of atrial contraction. The aim of the present study was to evaluate the influence of clinical and echocardiographic parameters: duration and cause of atrial fibrillation, different modality of cardioversion, and left atrial size with respect to the delay in the return of effective atrial contraction after cardioversion. Seventy patients were randomly chosen to undergo cardioversion by either direct current shock or intravenously administered procainamide hydrochloride. The 52 patients who had sinus rhythm restored underwent a complete Doppler echocardiographic examination 1 h after the restoration of sinus rhythm and after 1 day, 7 days, and 1 month. The relation between clinical variables and atrial ejection force was tested. Atrial ejection force was greater immediately and 24 h after cardioversion in patients who underwent pharmacologic therapy compared to patients treated with direct current shock (11.3+/‐3 versus 5+/‐2.9 dynes; P<0.001). In both groups atrial ejection force increased over time. The mode of cardioversion was significantly associated with recovery of left atrial mechanical function by day 1 in univariate and multivariate analysis (odds ratio, 0.14; 95% confidence interval, 0.02‐1.2). The other variable associated with the delay in the recovery of atrial function was a dilated left atrium (odds ratio, 0.16; 95% confidence interval, 0.12‐1.6). Atrial ejection force is a noninvasive parameter that can be easily measured after cardioversion and gives accurate information about the recovery of left atrial mechanical function. The recovery of left atrial function was influenced by the mode of cardioversion and left atrial size.

show abstract

“…In terms of atrial function, atrial size is regarded as a surrogate marker of function, with larger atria thought to represent a dysfunctional LA [6,7]. Several other parameters may be useful including the peak velocity of the A wave and its velocity time integral obtained from transmitral Doppler flow [8,9], atrial fraction [9,10], and atrial ejection force [10,11]. In addition, A' velocity using tissue Doppler imaging (TDI) for assessing global atrial function [12,13] and segmental atrial function can be evaluated using color Doppler tissue imaging (CDTI) [12], as well as strain and strain rate (SR) imaging [14,15].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with stroke in patients with paroxysmal atrial fibrillation beyond CHADS2 score

et al. 2016

View full text Add to dashboard Cite

Background: This study was conducted to investigate factors associated with stroke in patients with paroxysmal atrial fibrillation (PAF) beyond CHADS (0.6 ± 0.7 vs. 0.9 ± 0.7, p = 0.125). Patients with stroke had slightly lower body mass index (24.5 ± 2.7 vs. 23.4 ± ± 2.4, p = 0.052). Echocardiographic parameters did not show any differences in both systolic and diastolic functions between the two groups, however elevated E/E' ratio was noted (9.5 ± ± 3.8 vs. 11.6 ± 3.9, p = 0.010) due to higher E velocity (63.5 ± 15.9 vs. 70.9 ± 16.0 cm/s, p = 0.046) stroke (10.9 ± 9.9 vs. 22.1 ± 18.1 ms, p = 0.009) which indicates dyssynchronous contraction of LA. In multivariate analysis, SD of tA-SR (OR 1.074, p = 0.004) and elevated E/E' (OR 1.189, p = 0.048) were independently associated with stroke in patients with PAF. Conclusions: Elevated E velocity, E/E' and SD of tA-SR were associated with occurrence of stroke in patients with PAF even with similar CHAD scores. Increased SD of tA-SR and E/E' were independently associated with stroke in patients with PAF. (Cardiol J 2016; 23, 4: 429-436) . In the analysis of LA SR, there are no differences of SR among the 4 segments. However, standard deviations (SD) of time to peak SR (SD of tA-SR) of the 4 segments were higher in patients with

show abstract

Atrial ejection force: A noninvasive assessment of atrial systolic function

Cited by 207 publications

References 21 publications

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Doppler sonographic evaluation of left atrial function after cardioversion of atrial fibrillation.

Factors associated with stroke in patients with paroxysmal atrial fibrillation beyond CHADS2 score

Contact Info

Product

Resources

About