Some studies have shown that left ventricular structure and function play an important role in the risk stratifi cation and prognosis of cardiovascular disease.The clinical application of left atrial function in cardi...Some studies have shown that left ventricular structure and function play an important role in the risk stratifi cation and prognosis of cardiovascular disease.The clinical application of left atrial function in cardiovascular disease has gradually attracted attention in the cardiovascular fi eld.There are many traditional methods to evaluate left atrial function.Left atrial function related indexes measured by echocardiography has been identifi ed as a powerful predictor of cardiovascular disease in recent years,but they have some limitations.The left atrial function index has been found to evaluate left atrial function more effectively than traditional parameters.Furthermore,it is a valuable predictor of the risk stratifi cation and prognosis in patients with clinical cardiovascular disease such as heart failure,atrial fi brillation,hypertension,and coronary heart disease.展开更多
Objective To evaluate left atrial function in essential hypertension patients with different patterns of left ventricular geometric models by real-time three-dimensional echocardiography （RT-3DE） and left atrial tra...Objective To evaluate left atrial function in essential hypertension patients with different patterns of left ventricular geometric models by real-time three-dimensional echocardiography （RT-3DE） and left atrial tracking （EAT）.展开更多
The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV s...The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients.展开更多
Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Assoc...Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.展开更多
Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes wit...Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.展开更多
Introduction: The purpose of this study was to assess velocity-encoded cardiac magnetic resonance imaging (Ve-CMR) in a population of patients referred for cardiac magnetic resonance imaging (CMR), to determine the va...Introduction: The purpose of this study was to assess velocity-encoded cardiac magnetic resonance imaging (Ve-CMR) in a population of patients referred for cardiac magnetic resonance imaging (CMR), to determine the variability of atrial function, and to identify clinical parameters associated with left atrial function. Methods: This is a prospective study evaluating patients who were referred to our CMR center for a clinical CMR. Left atrial function was obtained via Ve-CMR thru-plane images across the mitral valve after acquiring 2 perpendicular in-plane images as “scouts”. The atrial function and mitral inflow were quantified by computer analysis (Argus, Siemens). Atrial function was defined as atrial contraction (A-wave) volume divided by total inflow volume. Left atrial volumes were calculated via computer analysis. Mitral regurgitation and left ventricular ejection fractions were assessed visually. Results: Thirty-nine patients, with mean age 56 +/- 10 years, were enrolled. The mean left atrial function was 22.9% +/-14.5%;the range in left atrial function was 0% - 57%. There was a significant positive correlation between atrial function and increased left ventricular ejection fraction (r = 0.44, P < 0.01). There was a significant negative correlation between atrial function and severity of mitral regurgitation (r = -0.60, P < 0.01), as well as left atrial volume (r = -0.36, P = 0.02). Conclusion: Our results indicate a wide variability in left atrial function and a significant association between left atrial function and left ventricular ejection fraction, left atrial volume and mitral regurgitation.展开更多
Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial vo...Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.展开更多
目的:应用四维自动左心房定量分析(4D Auto LAQ)技术评估经导管主动脉瓣置换术(TAVR)治疗患者术后早期左心房容积和功能改善情况。方法:选取2020年6月—2022年6月在四川省人民医院行TAVR的43例患者,分别于术前3 d及术后3月行心脏超声检...目的:应用四维自动左心房定量分析(4D Auto LAQ)技术评估经导管主动脉瓣置换术(TAVR)治疗患者术后早期左心房容积和功能改善情况。方法:选取2020年6月—2022年6月在四川省人民医院行TAVR的43例患者,分别于术前3 d及术后3月行心脏超声检查。常规测量二维超声心动图参数,应用4D Auto LAQ技术测量四维左心房容积及应变参数,分析TAVR患者手术前后各参数差异。结果:术后3月,TAVR患者主动脉瓣峰值血流速度(AV)较术前显著降低(P<0.001),左心房排空容积指数(LAEVI)、左心房被动排血容积(LAVp)、左心房被动排血容积指数(LAVIp)、左心房射血分数(LAEF)、左心房被动排血分数(LApEF)较术前增大(P<0.05),左心房最小容积(LAVmin)、左心房最小容积指数(LAVImin)、左心房最大容积(LAVmax)、左心房最大容积指数(LAVImax)、左心房主动收缩前容积(LAVpreA)、左心房主动收缩前容积指数(LAVIpreA)、左心房主动排空容积(LAVa)、左心房主动排空容积指数(LAVIa)较术前减小(P<0.05),左心房应变参数均较术前改善(P<0.05),而左心室舒张早期二尖瓣前向血流频谱(E峰)、左心房排空容积(LAEV)、左心房主动射血分数(LAaEF)变化不明显(P>0.05)。结论:4D Auto LAQ技术可有效评估TAVR治疗患者术后早期左心房容积和功能改善情况,有望为评价TAVR疗效提供可靠的参考指标。展开更多
基金This work was supported by grants from the National Natural Science Foundation of China(81800056),the Science&Technology Development Fund of Tianjin Education Commission for Higher Education(2017KJ137),and the Key Research and Development Program of Hunan Province(2019SK2021).Scientifi c research project approved by Hunan Provincial Health Commission(202103012117).
文摘Some studies have shown that left ventricular structure and function play an important role in the risk stratifi cation and prognosis of cardiovascular disease.The clinical application of left atrial function in cardiovascular disease has gradually attracted attention in the cardiovascular fi eld.There are many traditional methods to evaluate left atrial function.Left atrial function related indexes measured by echocardiography has been identifi ed as a powerful predictor of cardiovascular disease in recent years,but they have some limitations.The left atrial function index has been found to evaluate left atrial function more effectively than traditional parameters.Furthermore,it is a valuable predictor of the risk stratifi cation and prognosis in patients with clinical cardiovascular disease such as heart failure,atrial fi brillation,hypertension,and coronary heart disease.
基金Supported by the Natural Science Foundation of Liaoning ProvinceChina(2013023010)
文摘Objective To evaluate left atrial function in essential hypertension patients with different patterns of left ventricular geometric models by real-time three-dimensional echocardiography （RT-3DE） and left atrial tracking （EAT）.
文摘The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients.
文摘Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.
文摘Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.
文摘Introduction: The purpose of this study was to assess velocity-encoded cardiac magnetic resonance imaging (Ve-CMR) in a population of patients referred for cardiac magnetic resonance imaging (CMR), to determine the variability of atrial function, and to identify clinical parameters associated with left atrial function. Methods: This is a prospective study evaluating patients who were referred to our CMR center for a clinical CMR. Left atrial function was obtained via Ve-CMR thru-plane images across the mitral valve after acquiring 2 perpendicular in-plane images as “scouts”. The atrial function and mitral inflow were quantified by computer analysis (Argus, Siemens). Atrial function was defined as atrial contraction (A-wave) volume divided by total inflow volume. Left atrial volumes were calculated via computer analysis. Mitral regurgitation and left ventricular ejection fractions were assessed visually. Results: Thirty-nine patients, with mean age 56 +/- 10 years, were enrolled. The mean left atrial function was 22.9% +/-14.5%;the range in left atrial function was 0% - 57%. There was a significant positive correlation between atrial function and increased left ventricular ejection fraction (r = 0.44, P < 0.01). There was a significant negative correlation between atrial function and severity of mitral regurgitation (r = -0.60, P < 0.01), as well as left atrial volume (r = -0.36, P = 0.02). Conclusion: Our results indicate a wide variability in left atrial function and a significant association between left atrial function and left ventricular ejection fraction, left atrial volume and mitral regurgitation.
文摘Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.
文摘目的:应用四维自动左心房定量分析(4D Auto LAQ)技术评估经导管主动脉瓣置换术(TAVR)治疗患者术后早期左心房容积和功能改善情况。方法:选取2020年6月—2022年6月在四川省人民医院行TAVR的43例患者,分别于术前3 d及术后3月行心脏超声检查。常规测量二维超声心动图参数,应用4D Auto LAQ技术测量四维左心房容积及应变参数,分析TAVR患者手术前后各参数差异。结果:术后3月,TAVR患者主动脉瓣峰值血流速度(AV)较术前显著降低(P<0.001),左心房排空容积指数(LAEVI)、左心房被动排血容积(LAVp)、左心房被动排血容积指数(LAVIp)、左心房射血分数(LAEF)、左心房被动排血分数(LApEF)较术前增大(P<0.05),左心房最小容积(LAVmin)、左心房最小容积指数(LAVImin)、左心房最大容积(LAVmax)、左心房最大容积指数(LAVImax)、左心房主动收缩前容积(LAVpreA)、左心房主动收缩前容积指数(LAVIpreA)、左心房主动排空容积(LAVa)、左心房主动排空容积指数(LAVIa)较术前减小(P<0.05),左心房应变参数均较术前改善(P<0.05),而左心室舒张早期二尖瓣前向血流频谱(E峰)、左心房排空容积(LAEV)、左心房主动射血分数(LAaEF)变化不明显(P>0.05)。结论:4D Auto LAQ技术可有效评估TAVR治疗患者术后早期左心房容积和功能改善情况,有望为评价TAVR疗效提供可靠的参考指标。
