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Assessment of left atrial volume and function by real time three‐dimensional echocardiography in obese patients
Author(s) -
Yagmur Julide,
Cansel Mehmet,
Kurtoglu Ertugrul,
Hidayet Siho,
Acıkgoz Nusret,
Ermis Necip,
Ozyalin Fatma
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13417
Subject(s) - isovolumetric contraction , medicine , cardiology , ejection fraction , atrial natriuretic peptide , diastolic function , doppler echocardiography , diastole , end systolic volume , contraction (grammar) , stroke volume , heart failure , blood pressure
Objective To evaluate left atrial ( LA ) volume and functions in obese subjects using real time three‐dimensional echocardiography ( RT 3 DE ) and also the relationship between LA mechanical functions and N‐terminal pro‐atrial natriuretic peptide ( NT ‐pro ANP ). Methods This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT 3 DE to assess LA volume and mechanical function. Plasma NT ‐pro ANP was determined by ELISA method. Results There was no significant difference between groups in left ventricular ( LV ) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume ( LAV max), LAV max index ( LAVI ), LA minimal volume ( LAV min), before atrial contraction volume ( LAV preA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT ‐pro ANP levels were similar between groups. There were positive correlations between NT ‐pro ANP level and LAVI , LAV max, LAV min, LAV preA, and LA total and active emptying volumes. Conclusions Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.