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LEFT ATRIAL FUNCTION IN CONGESTIVE HEART FAILURE

By ΙΩΑΝΝΗΣ ΔΕΡΝΕΛΛΗΣ

Abstract

IN CONGESTIVE HEART FAILURE(CHF)LEFT ATRIAL CONTRIBUTE TO THE FAILING LEFT VENTRICLE FILLING AND UNDERGO ITSELF FAILURE.USING COMBINED TECHNIQUES OF ECHOCARDIOGRAM(FOR LEFT ATRIAL DIMENSION MEASUREMENT)AND RIGHT HEART CATHETERIZATION OR RETROGRADE NON-TRANSSEPTAL LEFT ATRIAL CATHETERIZATION(FOR PRESSURE MEASUREMENTS)LEFT ATRIAL FUNCTION WAS EVALUATED IN NORMAL SUBJECTS AND IN PATIENTS WITH CHF AT REST AND AFTER PHARMACOLOGICAL INTERVENTIONS THAT ARE COMMON IN THE CLINICAL PRACTISE.THE MAIN FINDINGS OF THIS STUDY IN CHF WERE:*CHANGESIN LEFT VENTRICULAR FILLING AFTER PHARMACOLOGICAL INTERVENTIONS ARE ATTRIBUTED NOT ONLY TO LEFT VENTRICULAR DIASTOLIC FUNCTION CHANGES BUT ALSO TO CO-ORDINATED CHANGES IN LEFT ATRIAL FUNCTION.*INVASIVE AND NON-INVASIVE INDICES OF LEFT ATRIAL SYSTOLIC AND DIASTOLIC FUNCTION CAN EVALUATE THE ATRIO-VENTRICULARCOUPLING.*IN GONGESTIVE HEART FAILURE LEFT ATRIAL VOLUME WAS INCREASED BUT LEFT ATRIAL EJECTION FRACTION WAS DECREASED.THUS,THE EMPTYING VOLUME REMAINEDCONSTANT OR MIGHT INCREASE.*THE PATTERN OF MITRAL FLOW VELOCITY WAS SIGNIFICANTLY ALTERED DURING HEMODYNAMIC INTERVENTIONS.ATRIAL KICK WAS A COMPENSATORYRESPONSE TO THE DECREASED EARLY FILLING.LOSE OF THIS ATRIAL FUNCTION MAY BE DUE TO THE INCREASED LOAD OF THE LEFT ATRIUM WHICH MAY CAUSE INTRINSIC LEFT ATRIAL DYSFUNCTION.*LEFT ATRIAL DYSFUNCTION DETERIORATE THE DECREASE LEFT VENTRICULAR FILLING IN PATIENTS WITH CHF.*NON.INVASIVE INDICES WHICH DISCRIMINATE INTRINSIC MYOCARDIAL DYSFUNCTION AND EXTRINSIC FACTORS (LOADING CONDITIONS)MIGHT BE THE LEFT ATRIAL EJECTION FORCE AND THE PRE

Publisher: National and Kapodistrian University of Athens
Year: 1997
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