Left Atrial Systolic Function Assessed by Left Atrial Ejection Force in Patients with Sick Sinus Syndrome and Paroxysmal Atrial Fibrillation

Abstract

SUMMARYWe evaluated left atrial systolic function using left atrial ejection force (LAEF) in 19 patients with sick sinus syndrome (SSS) and in 20 with paroxysmal atrial fibrillation (Paf) whose ages ranged from 48 to 80 years. We also evaluated 35 normal individuals for comparison. The LAEF was calculated as 1 / 3 × mitral valve area × (peak velocity of A wave) 2 using two-dimensional and pulsed-Doppler echocardiography according to Newton's law of motion and hydrodynamics. In normal individuals, LAEF positively correlated with age (r = 0.82, p < 0.01). Normal LAEF was calculated as 0.098 × age -0.74 (kdynes) from the regression line. Because of this correlation, we used age-corrected LAEF (%LAEF) that was calculated as (measured LAEF / normal LAEF) × 100. The results showed that this value was 53 ± 26% in patients with SSS and 54 ± 26% in patients with Paf. Both were significantly lower than normal individuals (p < 0.001). Among SSS subtypes, %LAEF was lower in types II and III than in type I (51 ± 14%, 37 ± 19%, and 81 ± 35%, respectively). In conclusion, left atrial systolic function is depressed in patients with Paf and SSS, in particular, types II and III. These results suggest that the pathological abnormalities extend not only to the sinus node but also to the left atrial muscle in patients with SSS and Paf. (Jpn Heart J 2000; 41: 723-732)

Evaluation of left atrial systolic function in noncompaction cardiomyopathy by real-time three-dimensional echocardiography

“…This fact could also affect our results, but no significant differences were found in age between NCCM patients and controls. LA systolic function is deteriorated in patients with sick sinus syndrome and in those with paroxysmal atrial fibrillation [ 16 ]. However, all of our patients were in sinus rhythm.…”

Proper Use of Left Atrial Ejection Force as a Measure of Left Atrial Mechanical Function

“…We agree that the method described by Dr. Zhong et al is more accurate than ours. It should be clarified that the modified Manning's formula described by them was previously presented by Tokushima et al 5 However, as we will discuss below, modifying the coefficient will not result in a significant change in our study interpretation. Additionally, the coefficient of “1/2” is more acceptable and more widely applied in the published literature.…”

“…They employed a hydrodynamic based method and tried to do a more accurate assessment. In fact, Manning used the coefficient of “1/2” in his original formula; while Zhong et al used the coefficient of “1/3” in the modified Manning's formula 5 : LAEF = 1/3 × MVA × peak A 2 …”

Atrial and ventricular ejection force of the fetal heart: Which of the four chambers is the dominant?

“…Abnormalities of ventricular ejection force of cardiac chambers are reported in a variety of cardiac pathologies in the fetuses, neonates, and adults. [1214151617181920212223242526272829]…”

“…[2829] Abnormally reduced LAEF indicates decreased atrial systolic function, and abnormally increased LAEF is indicative of ventricular diastolic dysfunction. [2627282930313233] Decreased LAEF has been reported in paroxysmal atrial fibrillation and sick sinus syndrome in adults and indicates poorer outcome after catheter ablation. [2730]…”