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Left Atrial Contribution to Left Ventricular Filling in Patients with Mitral Stenosis
Author(s) -
OKI TAKASHI,
IUCHI ARATA,
TABATA TOMOTSUGU,
YAMADA HIROTSUGU,
MANABE KAZUYO,
FUKUDA KAZUYO,
ABE MIHO,
FUKUDA NOBUO,
ITO SUSUMU
Publication year - 1998
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/j.1540-8175.1998.tb00576.x
Subject(s) - cardiology , medicine , sinus rhythm , pulmonary wedge pressure , stenosis , mitral regurgitation , mitral valve , mitral valve stenosis , doppler echocardiography , left atrial enlargement , left atrial pressure , atrial fibrillation , hemodynamics , blood pressure , diastole
We recorded transmitral and pulmonary venous flow velocities using transthoracic continuous‐wave and transesophageal pulsed Doppler echocardiography, respectively, in 36 patients with mitral stenosis who were in sinus rhythm to investigate the left atrial contribution to left ventricular filling in mitral stenosis. The mitral valve area was determined by transthoracic two‐dimensional short‐axis echocardiography. Patients were classified as having mild stenosis (± 1.5 cm 2 , n = 17) or moderate stenosis (< 1.5 cm 2 , n = 19). The mean pulmonary capillary wedge pressure and left atrial maximal diameter were significantly larger, and left atrial volume change during atrial contraction was significantly smaller in the moderate group than in the mild group. The percent left atrial contribution to left ventricular filling, estimated from the transmitral flow velocity, the peak atrial systolic velocity, and the percent ratio of left atrial systolic regurgitation to left atrial filling, estimated from the pulmonary venous flow velocity, were significantly lower in the moderate group than in the mild group. The percent left atrial contribution to left ventricular filling, the peak atrial systolic velocity, and the percent ratio of left atrial systolic regurgitation to left atrial filling were positively correlated with the mitral valve area and negatively correlated with the mean pulmonary capillary wedge pressure. These results suggest that the left atrial contribution to left ventricular filling in patients with mitral stenosis in sinus rhythm decreases as the severity of valve stenosis increases, and that analysis of the atrial systolic waves of the transmitral and pulmonary venous flow velocities provides important information for evaluation of left atrial systolic performance in patients with mitral stenosis.