The reservoir function of the left atrium during ventricular systole

Grant, Colin A.; Bunnell, Ivan L.; Greene, David G.

doi:10.1016/0002-9343(64)90210-4

Cited by 158 publications

(42 citation statements)

References 4 publications

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“…[20][21][22] Theoretically, AF causes a functional loss of the left atrium, especially the loss of contractile function. An observation from De Ferrari, et al 23) , namely, that AF leads to a more severe disease rating in the New York Heart Association classification, indicates that AF aggravates heart failure.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Cardiopulmonary Exercise Testing in Cardiac Patients With Atrial Fibrillation

et al. 2012

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SummaryParameters obtained from cardiopulmonary exercise testing (CPX) are recognized for their high prognostic value in predicting future cardiac events in cardiac patients. Our group compared the prognostic value of CPX parameters between patients with sinus rhythm (SR) and patients with atrial fibrillation (AF).Peak O2 uptake (VO2), the ratio of the increase in VO2 to the increase in work rate ( ∆VO2/ ∆WR), and the slope of the increase in ventilation to the increase in CO2 output (VE-VCO2 slope) were obtained from CPX in 72 AF patients and 478 SR patients. The prognostic values of these indices were compared between the two groups.Six cardiac deaths and 25 cardiac events were observed in the AF group and 9 cardiac deaths and 96 cardiac events were observed in the SR group, over a prospective follow-up period of 1,192 days. The percentages of cardiac deaths and cardiac events were higher in the AF group than in the SR group. In a multivariate Cox proportional hazards analysis, peak VO2 was identified as a sole significant predictor of cardiac death and cardiac events in SR patients and VE-VCO2 slope was identified as a sole significant predictor of cardiac death and cardiac events in AF patients.Our results suggest that the VE-VCO2 slope is strongly predictive of future cardiac events in patients with AF and that peak VO2 is strongly predictive of future cardiac events in SR patients. (Int Heart J 2012; 53: 102-107)

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Cardiopulmonary Exercise Testing in Cardiac Patients With Atrial Fibrillation

et al. 2012

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“…Estima-se que 42% do volume sistólico (stroke volume) do VE estejam armazenados no AE durante a sístole ventricular, ressaltando a importância da função de reservatório do AE no débito cardíaco 1 …”

Section: Função De Reservatóriounclassified

“…Ao 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 .…”

Section: Introductionunclassified

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Matsumoto¹,

Mancuso²,

Tatani³

et al. 2014

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

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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...

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“…We evaluated LA function by ARV, PEV, AEV, and their values corrected by SV. 5,6,9,10,18 NIH image V1.61 (Wayne Rasband, National Institutes of Health), image-processing software 19 was used to obtain the FVC. We imported PVF and LVIF spectra during 1 cardiac cycle from the peak of the R wave on the ECG into the computer.…”

Section: Computation Of Fvcmentioning

confidence: 99%

“…1-8 LA function has 3 components: reservoir, conduit and booster pump functions. 5,6,9,10 The reservoir function indicates the storage capacity for pulmonary venous (PV) return by LA distension during ventricular systole. During ventricular diastole, the LA works as a conduit for blood flow from the PV to the left ventricle (LV).…”

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confidence: 99%

Evaluation of Left Atrial Function by the Functional Volume Change Curve Derived From Doppler Flow Spectra.

et al. 2001

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eft atrial (LA) function can be evaluated by measuring pressure and volume, constructing the pressurevolume relationship and the dimensional changes of the LA can replace LA volume. 1-8 LA function has 3 components: reservoir, conduit and booster pump functions. 5,6,9,10 The reservoir function indicates the storage capacity for pulmonary venous (PV) return by LA distension during ventricular systole. During ventricular diastole, the LA works as a conduit for blood flow from the PV to the left ventricle (LV). The booster pump function indicates the filling blood volume to the LV during atrial systole. Recently, it is shown that atrial natriuretic peptide (ANP) synthesis is activated by the stimulus of atrial stretch, and the booster pump function of LA is strongly related to the release of ANP. 11,12 Therefore, it is important to estimate the LA function in detail to understand the hemodynamic status of patients with heart failure.In spite of its importance, it is difficult to estimate LA function, particularly the 3 components of LA function, because of the difficulty in determining the change in LA volume correctly. Thus, we developed a new method for measuring the LA volume change independent of the LA shape using Doppler flow spectra. PV flow (PVF) velocity and LV inflow (LVIF) velocity were measured by Doppler echocardiography, and from these flow velocity data the Japanese Circulation Journal Vol. 65, November 2001 LA functional volume change curve (FVC) was constructed by a newly developed algorithm described in detail in the Methods section. Using the FVC, we evaluated LA reservoir and booster pump functions, respectively, in patients with normal and abnormal LV diastolic function. Methods Study PatientsThe 110 consecutive patients (male 68, female 42) who did not have mitral regurgitation were enrolled in this study. The mean age of the population was 61.6±12.5 years (range, 26-86). The following heart diseases were involved: coronary artery disease, 42; myocarditis, 11; hypertrophic cardiomyopathy, 4; dilated cardiomyopathy, 4; aortic regurgitation, 2; ventricular septal defect, 2; sick sinus syndrome, 1. Thirty-two patients had no heart disease, 4 had respiratory disease and 8 had undergone hemodialysis. Transthoracic EchocardiographyEchocardiography was performed using ALOKA SSD-2200 with a 2.5 MHz probe in the left lateral decubitus position during quiet respiration. The variability of the R-R interval never exceeded ±5%. 13 To record LVIF, the sample volume was placed at the mitral tip in the left anterior oblique-like view. 14,15 For PVF, the color Doppler method was used to identify the PV orifice and the sample volume was placed at the right or left upper PV within 15 mm of its orifice in either the 4-or 2-chamber view. 15,16 Standard M-and B-mode echocardiography was recorded and % fractional shortening (%FS) and stroke volume (SV) were calculated from M-mode echocardiography.

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The reservoir function of the left atrium during ventricular systole

Cited by 158 publications

References 4 publications

Prognostic Value of Cardiopulmonary Exercise Testing in Cardiac Patients With Atrial Fibrillation

Prognostic Value of Cardiopulmonary Exercise Testing in Cardiac Patients With Atrial Fibrillation

Echocardiographic Evaluation of Left Atrial Function: Physiological and Clinical Aspects

Evaluation of Left Atrial Function by the Functional Volume Change Curve Derived From Doppler Flow Spectra.

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