Abstract
PurposeTo assess the impact of left ventricular (LV) diastolic dysfunction on left atrial (LA) phasic volume and function using dual-source CT (DSCT) and to find a viable alternative prognostic parameter of CT for LV diastolic dysfunction through quantitative evaluation of LA phasic volume and function in patients with LV diastolic dysfunction.Materials and MethodsSeventy-seven patients were examined using DSCT and Doppler echocardiography on the same day. Reservoir, conduit, and contractile function of LA were evaluated by measuring LA volume (LAV) during different cardiac phases and all parameters were normalized to body surface area (BSA). Patients were divided into four groups (normal, impaired relaxation, pseudonormal, and restrictive LV diastolic filling) according to echocardiographic findings. The LA phasic volume and function in different stages of LV diastolic function was compared using one-way ANOVA analysis. The correlations between indexed volume of LA (LAVi) and diastolic function in different stages of LV were evaluated using Spearman correlation analysis.ResultsLA ejection fraction (LAEF), LA contraction, reservoir, and conduit function in patients in impaired relaxation group were not different from those in the normal group, but they were lower in patients in the pseudonormal and restrictive LV diastolic dysfunction groups (P < 0.05). For LA conduit function, there were no significant differences between the patients in the pseudonormal group and restrictive filling group (P = 0.195). There was a strong correlation between the indexed maximal left atrial volume (LAVmax, r = 0.85, P < 0.001), minimal left atrial volume (LAVmin, r = 0.91, P < 0.001), left atrial volume at the onset of P wave (LAVp, r = 0.84, P < 0.001), and different stages of LV diastolic function. The LAVi increased as the severity of LV diastolic dysfunction increased.ConclusionsLA remodeling takes place in patients with LV diastolic dysfunction. At the same time, LA phasic volume and function parameters evaluated by DSCT indicated the severity of the LV diastolic dysfunction. Quantitative analysis of LA phasic volume and function parameters using DSCT could be a viable alternative prognostic parameter of LV diastolic function.
Highlights
The left atrium serves as a reservoir, conduit, and booster pump during the cardiac cycle [1]
left atrial (LA) phasic volume and function parameters evaluated by dual-source CT (DSCT) indicated the severity of the left ventricular (LV) diastolic dysfunction
There is no report about LA volume (LAV) and LV diastolic dysfunction evaluated by CT, and neither the relationship between LA phasic function and LV diastolic dysfunction has been evaluated by CT
Summary
The left atrium serves as a reservoir, conduit, and booster pump during the cardiac cycle [1]. Conduit, and contractile functions, the left atrium plays an integral role in cardiac performance by modulating LV filling [2]. It has been demonstrated that there is significant correlation between LAV and LV diastolic dysfunction [4]. Almost all the results about LAV and LV diastolic dysfunction have been reported in studies involving echocardiography [5,6,7,8,9]. There is no report about LAV and LV diastolic dysfunction evaluated by CT, and neither the relationship between LA phasic function and LV diastolic dysfunction has been evaluated by CT
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