Effect of left ventricular contractile performance on passive left atrial filling—Clinical study using radionuclide angiography

Abstract

Many invasive and noninvasive methods have been used to study the cardiac atria; however, few allow quantitative measurement of atrial function. To determine the interaction between left ventricular (LV) contraction and left atrial (LA) filling, gated radionuclide angiography was conducted in 30 normal subjects (24 men and 6 women, mean age 58 +/- 10 years, range 26-68). LV and LA time-activity curves and their first-derivative curves were obtained simultaneously by using the method of Bough et al. The LV ejection fraction (64 +/- 18%) and LV peak ejection rate (LVPER; 3.42 +/- 0.27 EDV/s) were computed from these curves. As indices of LA filling, LA fractional emptying (38 +/- 12%) and LA peak filling rate (LAPFR; 2.86 +/- 0.17 LAVmax/s)--the latter being defined as the peak rate of LA filling during the LA filling phase--were also computed from these curves. In all subjects, the timing of the LVPER coincided with the occurrence of LAPFR, and there was a significant positive correlation between the LVPER and LAPFR (r = 0.81, p < 0.001), indicating that the LAPFR was strongly affected by the degree of LVPER. Thus, these results indicate that LV contractile performance plays an important role in determining LA passive filling during ventricular systole.

Left atrial flow propagation velocity: a new approach for assessment of left atrial reservoir function

“…LV systolic function also plays an important role in determining early LA reservoir function. During LV systole, the descent of cardiac base toward the apex draws additional blood from pulmonary veins into the LA [25]. In the later phase of LA reservoir period, right ventricular systolic pressure contributes to the increase in LA pressure and volume [26].…”

Isolated pulmonary regurgitation causes decreased right ventricular longitudinal function and compensatory increased septal pumping in a porcine model

“…The data presented in this manuscript, however, support the idea that isolated PR also results in reduced longitudinal RV pumping and is therefore independent of surgery or scarring. Atrial filling and longitudinal ventricular pumping are closely intertwined processes . The displacement of the AVP during ventricular systole draws blood into the atria, similar to the piston aspirating liquid into a syringe.…”

Changes in ductus venosus flow profile in twin–twin transfusion syndrome: role in risk stratification

“…Unlike the umbilical vein, the flow in the DV is phasic and provides information on atrial pressure‐volume changes during the cardiac cycle. During atrial relaxation, rapid filling of the atria occurs, which is augmented by the descent of the atrioventricular ring during ventricular systole and reflected by an increase in the DV velocity that peaks at the S‐wave. Ventricular relaxation results in a decrease in DV velocity during late systole (v‐wave).…”