Two-Dimensional echocardiographic determination of left atrial emptying volume: A noninvasive index in quantifying the degree of nonrheumatic mitral regurgitation

Ren, Jian‐Fang; Kotler, Morris N.; DePace, Nicholas L.; Mintz, Gary S.; Kimbiris, Demetrios; Kalman, Peter G.; Ross, John

doi:10.1016/s0735-1097(83)80313-1

Cited by 133 publications

(47 citation statements)

References 22 publications

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“…9 Left atrial volume was measured according to the modified biplane area -length method. 10,11 After obtaining the rest images in the standard parasternal and apical views, multistage supine Background Because the ratio of mitral inflow and annular velocity to stroke volume has been reported as an index of diastolic elastance (Ed), the hypothesis tested in the present study was that Ed during exercise would be more abnormal in female than in male patients with type 2 diabetes. …”

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confidence: 99%

Gender-Related Difference in Left Ventricular Diastolic Elastance During Exercise in Patients With Diabetes Mellitus

Lee

Park

et al. 2008

Circ J

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iabetes mellitus is an important cause of heart failure (HF). In clinical trials of HF the prevalence of diabetes ranges from 10% to more than 30% 1 and the outcome of such patients with HF is worse than that of patients without diabetes. Interestingly, the risk of HF in diabetic patients is higher in women than in men, even after adjusting for other risk factors. 2 Moreover, women with HF tend to experience more symptoms than men and the number of hospitalizations is higher among women than among men. 3 It also has been shown that women with HF more often have preserved left ventricular (LV) systolic function. [4][5][6] Using the ratio of mitral inflow and annular velocities (E/E') over stroke volume (SV) as an index of diastolic elastance (Ed) has been reported 7 and it offers advantages in examining the relationship between gender and Ed during exercise as well as at rest. We hypothesized that Ed during exercise would be more abnormal in women than in men among patients with type 2 diabetes. Circulation Journal Vol.72, September 2008 Methods Study PopulationThe study population comprised 53 patients (27 males, mean age 53±14 years) with type 2 diabetes and 53 age-and gender-matched controls. The patients with diabetes had no symptoms or signs of heart disease, were in sinus rhythm and had a normal resting 12-lead ECG. Exclusion criteria were significant atrial or ventricular arrhythmia, significant valvular diseases (≥moderate severity), significant coronary artery disease, prior history of myocardial infarction, depressed LV systolic function (ejection fraction (EF) <50%) or any regional wall motion abnormality, pericardial disease, and unable to exercise. The control subjects were considered to have a low probability of coronary artery disease on clinical grounds and had a normal exercise stress echocardiogram. Because this study's aim was to examine diabetes as an independent disease contributing to myocardial dysfunction, patients who had coexisting hypertension were excluded. Study approval was obtained from the Internal Review Board of Yonsei University College of Medicine. The 2-Dimensional (D) and Exercise Doppler Echocardiography (Diastolic Stress Echocardiography) 8Standard 2-D measurements (LV diastolic and systolic dimensions, ventricular septum and posterior wall thickness, left atrial volume, LV outflow tract diameter) were obtained with the patient in the left lateral position. LVEF was calculated by the modified Quinones method. 9 Left atrial volume was measured according to the modified biplane area -length method. 10,11 After obtaining the rest images in the standard parasternal and apical views, multistage supine Background Because the ratio of mitral inflow and annular velocity to stroke volume has been reported as an index of diastolic elastance (Ed), the hypothesis tested in the present study was that Ed during exercise would be more abnormal in female than in male patients with type 2 diabetes. Methods and ResultsEd was measured at rest and during graded supine bicycle exercise (25W, 3...

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confidence: 99%

Gender-Related Difference in Left Ventricular Diastolic Elastance During Exercise in Patients With Diabetes Mellitus

Lee

Park

et al. 2008

Circ J

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“…Following obtaining the best image of LA from the apical four chamber window, maximal and minimal LA volumes were measured by carefully tracing its edges manually and applying the biplane area-length method. 11,12,13) Maximal LA volume was measured at the frame of mitral valve opening. The minimal LA volume was measured at the frame of the mitral valve closure.…”

Section: Methodsmentioning

confidence: 99%

Left Atrial Maximum Volume Is a Recurrence Predictor in Lone Atrial Fibrillation. An Acoustic Quantification Study.

et al. 2002

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SUMMARYPredictors of recurrence in lone atrial fibrillation have not been clearly identified. Acoustic quantification (AQ) is a promising method in the assessment of left atrial (LA) volumes. The purpose of the present study was to investigate the potential of LA volumes obtained by standard manual tracing and AQ methods in predicting AF-recurrence after restoring the sinus rhythm in patients with lone AF, and to test the agreement between the two approaches. Standard echocardiography combined with AQ was performed in 28 patients with lone AF one hour after the sinus rhythm was regained, and in 10 controls. LA volumes were determined by conventional manual tracing and AQ methods. AQ waveforms of LA were obtained by drawing a region of interest around the LA border. The agreement of the two methods was tested by Bland-Altman analysis. Patients were followed up for 6 months for the occurrence of AF recurrence. A good correlation was observed between AQ and manual tracing methods in determining both minimal (r=0.59) and maximal (r=0.88) LA volumes. Patients with AF recurrence had a significantly larger maximum LA volume as assessed with both methods (P<0.05 for both). M-mode derived LA dimension and isovolumic relaxation time were additional predictors of recurrence in patients with lone AF. In lone AF, patients prone to recurrence could be predicted by determining LA maximum volume assessed either by AQ or manual tracing methods. AQ provides on-line, accurate estimation of LA volumes. (Jpn Heart J 2002; 43: 241-248)

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“…12 Left atrial (LA) volume was calculated using the prolate ellipsoid model. 13 From mitral Doppler tracings with the sample volume at the mitral leaflet tips, the following variables were measured: peak velocity of early rapid filling wave (E), peak flow velocity at atrial contraction (A), E/A ratio, and deceleration time of early filling. A restrictive LV filling pattern was defined as an E/A ratio >2, with a deceleration time of <150 ms. 14 Early and late diastolic tissue Doppler velocities (E' and A') were measured at the medial mitral annulus using a tissue Doppler image.…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

Mechanism of Mitral Regurgitation in the Acute Phase of Inferior Wall Myocardial Infarction - Reduced Closing Force as a Consequence of Left Ventricular Systolic Dysfunction in the Presence of Tethering as a Determinant of Mitral Regurgitation -

Hong

Kim

Hur

et al. 2011

Circ J

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Background:To delineate the mechanism of mitral regurgitation (MR) in the acute phase of inferior wall myocardial infarction (MI). Methods and Results:In 97 patients (age 59±12 years) with acute inferior wall MI, the severity of MR, left ventricular (LV) geometric changes and function within 1.7±1.3 days after MI by echocardiography was retrospectively evaluated. Infarct size was measured within 3.9±1.7 days by cardiac magnetic resonance. Mild MR was present in 16 (16.5%) and moderate MR in 12 (12.4%) of 97 patients. There were no significant differences in mitral annular area, sphericity and distances between papillary muscle tips and the contralateral mitral annulus. However, patients with moderate MR had significantly larger LV end-systolic volume, tenting area and infarct size. There was a graded relationship between the severity of MR and LV ejection fraction. In a multivariable regression analysis, LV ejection fraction and tenting area were found to be independent predictors of the severity of MR (r 2 =0.180, P=0.001).Conclusions: MR was associated with LV systolic dysfunction, increase in end-systolic LV volume and tethering of mitral leaflet, suggesting reduced closing force as a consequence of LV systolic dysfunction in the presence of leaflet tethering would play a more pivotal role in the development of MR. (Circ J 2011; 75: 619 - 625)

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Two-Dimensional echocardiographic determination of left atrial emptying volume: A noninvasive index in quantifying the degree of nonrheumatic mitral regurgitation

Cited by 133 publications

References 22 publications

Gender-Related Difference in Left Ventricular Diastolic Elastance During Exercise in Patients With Diabetes Mellitus

Gender-Related Difference in Left Ventricular Diastolic Elastance During Exercise in Patients With Diabetes Mellitus

Left Atrial Maximum Volume Is a Recurrence Predictor in Lone Atrial Fibrillation. An Acoustic Quantification Study.

Mechanism of Mitral Regurgitation in the Acute Phase of Inferior Wall Myocardial Infarction - Reduced Closing Force as a Consequence of Left Ventricular Systolic Dysfunction in the Presence of Tethering as a Determinant of Mitral Regurgitation -

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