Prognostic Significance of Left Atrial Volume Index in Acute Myocardial Infarction and its Angiographic Correlation

Evaluating left atrium volume is a good way to estimate prognosis in acute myocardial infarction patients because it indicates to time and severity of diastolic dysfunction and longer-term results of acute myocardial infarction. Left atrial (LA) volume is a prognostic predictor across a wide spectrum of cardiac and non-cardiac diseases. Aim: To assess the left atrial volume index in Myocardial Infarction & Angiographic correlation and to assess any correlation between with left atrial volume index and outcomes of MI such as heart failure, short term mortality, arrhythmias, and ejection fraction. Methods: 100 patients with ST elevation in ECG, with history, examination, ECG changes and elevated CK-MB, Anterior, Inferior, Right ventricle & Posterior wall Myocardial infarction were included. The patients were studied considering demographic factors, risk factors, echocardiography indexes such as systolic and diastolic functions and left atrium volume and angiography. Results: Among LAVI >34, 22 had (70-90%) of RCA, 7 had (70-90%) of LCX, 29 had (70-90%) of LAD. Among LAVI>34, 14 patients had TVD, 5 had DVD, 29 had SVD, 9 normal coronaries, which are not statistically significant. Among LAVI >34, 22 patients undergone PCI, 7 patients underwent CABG, 1 patient had CHB, 3 patient had VT and 9 patients had AF, which is statistically significant. Among LAVI>34, 24 patients had HF at 30 days follow-up. Among LAVI>34, in 30 days follow up 1 patient expired. When compared with LAVI <34 it was not statistically significant. Conclusion: LA Volume index provides prognostic information incremental to clinical data and standard Echocardiographic predictors of outcome, including LV systolic function and Doppler assessment of Diastolic Function.

To investigate atrial septum and right atrial appendage pacing for prevention of new-on atrial fibrillation / 安徽医科大学学报

66 patients with sick sinus syndrome were enrolled in this study. All patients meeting the indications for dual chamber pacing were randomly divided into two groups: right atrial appendage(RAA) pacing group was made up of 36 patients and low atrial septal(LAS) pacing group was made up of 30 patients. Follow-up was 12 months. The incidence of atrial fibrillation(AF) was lower in LAS group(3. 3% ) compared with the RAA group(19. 4% );P wave dispersion in RAA group was significantly higher than that in the LAS group (P < 0. 01). After 3 months of the operation, left atrial volume index(LAVI) in RAA group was significantly larger than that in the LAS group. In LAS group compared with the RAA group P wave dispersion and LAVI were significantly lower after operation in sick sinus syndrome. LAS pacing was superior to RAA pacing in preventing new atrial fibrillation.

Changes of echocardiographic indices in patients receiving catheter ablation for atrial fibrillation with ;different outcomes / 实用医学杂志

Objective To explore the changes of different echocardiographic indices in patients receiving catheter ablation for atrial fibrillation with different outcomes. Methods 75 patients received catheter ablation for atrial fibrillation during the period of January 2012 to February 2014. Before and 6 monthes after ablation , all the patients were examined left atrial volume index (LAVi), left atrium pressure (LAP), and left atrial ejection force (LAF) with echocardiography. Then after 6 months, according to the outcomes of the procedure, we divided the patients into two groups and compared the changes of these three parameters. Results In sinus group, LAVi decreased while LAF increased after treatment [LAVi: (29.3 ± 1.9) vs. (41.2 ± 9.3), LAF:(1.31 ± 0.61) (kg·cm)/s2 vs. (0.83 ± 0.22) (kg·cm)/s2, P 0.05]; while in recurrent group, there were no changes in LAVi, LAP, and LAF after treatment (P > 0.05). Conclusions Radiofrequency catheter ablation is safe and effective in treatment of atrial fibrillation, resulting in significant improvements in left atrial volume and cardiac function.

Relationship of left atrial volume index and vasovagal syncope / 中华实用儿科临床杂志

Objective To explore the relationship between the volume and function of the heart and the pathogenesis of vasovagol syncope (VVS) through the detection of the left atrial volume index(LAVI).Methods The 68 cases in the observation group were diagnosed as VVS and hospitalized in the First Hospital of Jilin University from Jan.1 to Dec.31 in 2012.The 60 cases in the control group were children and adolescents receiving healthy physical examinations during the same period.All the patients were given the examination of heart color Doppler ultrasound,head up tilt test(HUT),body height,body mass,chest X-ray and accounted the LAVI and cardiothoracic ratio was accounted.Results The average age in the observation group and the control group was(12.19 ± 2.01) and(12.15 ± 2.00) years old,respectively.And there was no statistically significant difference in age between these two groups (t =0.10,P ＞0.05).There were 23 boys and 45 girls in the observation group,and 31 boys and 29 girls in the control group.There was statistically significant difference in the ratio of gender composition between these two groups (x2 =4.16,P ＜ 0.05).The LAVI values in these two groups were (21.23 ± 2.04) mL/m2 and (23.45 ± 3.01) mL/m2,respectively.There was statistically significant difference between two groups(t =4.29,P ＜ 0.05).The LAVI values in VVS mixed inhibition (VVS-MI),VVS vascular inhibition (VVS-VI) and VVS cardiac inhibition (VVS-CI) were (21.41 ± 2.98) mL/m2,(21.06 ± 2.59) mL/m2 and(21.23 ± 3.22) mL/m2,respectively.There were statistically significant differences between VVS-MI or VVS-VI and the control groups(t =3.27,3.36,all P ＜ 0.05),but there was no statistically significant difference between VVS-CI and control groups(t =1.61,P ＞ 0.05).The cardiothoracic ratio were 0.43 ± 0.07 and 0.46 ± 0.06 in the observation group and the control group,respectively,and there was statistically significant difference between these two groups(t =3.05,P ＜0.05).Conclusions The pathogenesis of VVS is related to the size and function of left heart.The children and adolescents with smaller LAVI and cardiothoracic ratio are more susceptible to VVS.

The diagnostic value of left atrial volume index for heart failure with preserved ejection fraction / 实用医学杂志

Objective To explore the value of left atrium volume index (LAVI) in the diagnosis of heart failure with preserved ejection fraction (HFPEF). Methods Seventy-seven patients with HFPEF and 33 patients without HFPEF who had been treated from May 2012 to September 2013 in Guangdong General Hospital were en-rolled. The clinical data and a series of ultrasound parameters were collected and analysed. The relationship between LAVI, LAV, and other indexes of diastolic function was determined by Pearson correlation analysis. The value of LAVI and LAV for diagnosing HFPEF was compared by the ROC curve. Results LAVI and LAV of were signifi-cantly greater in HFPEF group than in non-HFPEF group. LAV and LAVI were significantly associated wtih HEPEF. The area under the ROC curve (AUC) of LAVI increased significantly as compared with the AUC of LAV (0.832 vs. 0.799, P<0.05). With a cut-off value of 30 mL/m2, the specificity and sensitivity for diagnosing HEPEF were 64.9%and 84.8%, respectively. Conclusions LAVI may be valuable in the diagnosis of HFPEF.

Left Atrial Volume Index as Indicator of Left Ventricular Diastolic Dysfunction: Comparation between Left Atrial Volume Index and Tissue Myocardial Performance Index

BACKGROUND: To point out a possible correlation between left atrial volume index (LAVI) and left ventricular (LV) diastolic time interval to better define LV diastolic dysfunction, this study was performed. METHODS: In 62 hypertensive-hypertrophic patients without LV systolic dysfunction, LV volumes, myocardial mass index, ejection fraction% (EF%) and LAVI were measured by two-dimensional echocardiography. Instead, tissue Doppler echocardiography (TDE) was used to measure myocardial performance index (MPI) and its systo-diastolic time intervals, such as: iso-volumetric contraction time (IVCT); iso-volumetric relaxation time (IVRT); ejection time. LAVI, TDE-MPI and time intervals where also measured in 15 healthy controls, to obtain the reference values. RESULTS: Results shown a significant increase of LV volumes in hypertensives in comparison to the control group (p < 0.05). LV mass index also augmented (p < 0.001). Instead, EF% not significantly changed in hypertrophic patients in comparison with healthy controls. LAVI raised in hypertensives wih left ventricular hypertrophy, whereas IVCT resulted within the normal limits. On the contrary, IVRT significantly raised. Accordingly, MPI resulted higher in controls. CONCLUSION: LAVI, MPI and its time intervals appear as reliable tools to non-invasively individualize LV diastolic dysfunction in systemic hypertension, in absence of mitral valve disease.

Left Atrial Volume Index as Indicator of Left Ventricular Diastolic Dysfunction: Comparation between Left Atrial Volume Index and Tissue Myocardial Performance Index

BACKGROUND: To point out a possible correlation between left atrial volume index (LAVI) and left ventricular (LV) diastolic time interval to better define LV diastolic dysfunction, this study was performed. METHODS: In 62 hypertensive-hypertrophic patients without LV systolic dysfunction, LV volumes, myocardial mass index, ejection fraction% (EF%) and LAVI were measured by two-dimensional echocardiography. Instead, tissue Doppler echocardiography (TDE) was used to measure myocardial performance index (MPI) and its systo-diastolic time intervals, such as: iso-volumetric contraction time (IVCT); iso-volumetric relaxation time (IVRT); ejection time. LAVI, TDE-MPI and time intervals where also measured in 15 healthy controls, to obtain the reference values. RESULTS: Results shown a significant increase of LV volumes in hypertensives in comparison to the control group (p < 0.05). LV mass index also augmented (p < 0.001). Instead, EF% not significantly changed in hypertrophic patients in comparison with healthy controls. LAVI raised in hypertensives wih left ventricular hypertrophy, whereas IVCT resulted within the normal limits. On the contrary, IVRT significantly raised. Accordingly, MPI resulted higher in controls. CONCLUSION: LAVI, MPI and its time intervals appear as reliable tools to non-invasively individualize LV diastolic dysfunction in systemic hypertension, in absence of mitral valve disease.