Passive Emptying Fractions Research Articles

Evaluation of the changesof left atrial function in patients with hypertension by left atrial volume trackingmethod

：Objective To probe intothe clinical value of left atrial(LA) volme tracking method (LAVT) on the assessment ofleft atrial function in patients with hypertension. Methods Thirty-one patients withhypertension and 31 control subjects were involved. Images of apical two-chamber andfour-chamber views were obtained by two-dimensional echocardiography. LA maximal volume(LAVmax), LA minimal volume (LAVmin), LA presystolic volume (LAVpre), systolic LA fillingrate (dv/dtS), early diastolic LA emptying rate (dv/dtE) and late diastolic LA emptyingrate (dv/dtA) were derived using LAVT. LA passive emptying volume(LAVp), LA passiveemptying fraction(LAVpEF), LA active emptying volume(LAVa), LA active emptying fraction(LAVaEF), LA total emptying volume (LAVt), LA total emptying fraction(LAVtEF) werecalculated. All volume measurements were corrected to body surface area (LAVI). ResultsThere were significant differences in the LAVImax, LAVImin, LAVIpre, LAVpEF, LAVIa,LAVIt,dv/dtS, dv/dtA between hypertensive patients and control subjects(P <0.05~0.001),but no significant differences were found in the LAVp, LAVaEF, LAVtEF,dv/dtE between thetwo groups. The LAVImax has shown significant positive correlation with LAVIp, LAVIa andLAVIt(r = 0.588~0.812, P <0.001). LAVaEF has shown positive correlation with theLAVtEF(r = 0.833, P<0.001), whereas LAVpEF has not(r = 0.420, P <0.01). There was asignificant positive correlation with LAVImax and LAVIpre(r = 0.908, P <0.001), LAVIpreand LAVIa(r = 0.689, P <0.001) ,dv/dtE and LAVIp(r = 0.690, P <0.001),dv/dtA andLAVIa(r = 0.600, P <0.001). Conclusions In hypertensive patients,left atrial reservoirfunction and booster pump function increase, while left atrial conduit function decreases.LAVT has a potential ability to evaluate left atrial function.

Relationship between ventricular wall motion state, infarction size and left atrial function in patients with myocardial infarction

Objective To assess the influence of the wall motion state and the infarct size of myocardial on left atrial(LA) function in patients with myocardial infarction(MI), and to investigate the main determinants of LA function. Methods LA function of the small area of MI group (group A), the large area of MI group (group B) and control.group were compared,and the influence of the infarct size on LA function was evaluated. The correlation between parameters of LA function and wall motion score index (WMSI) was analyzed. Stepwise regression was made to determine the influencing factors of LA function. index (VpreⅠ),LA active emptying volume index (AEVI), LA ejection force index (EFI) of group A and group B were larger than those of control group,and the parameters of group B were also larger than those of group A(P<0.05). LA passive emptying fraction (PEF) and atrial expansion index (AEI) of group A and group B were smaller than those of control group,and the parameters of group B were also smaller than regression equation. Conclusions With the increasing of areas of infarction and the aggravating of wall motion sate,the LA remodeling aggravated. The boost pump function of LA augmented, and the function of conduit and reservoir of LA was reduced. Wall motion state, LV remodeling and LV diastolic function were the major determinants of augmented LA function in MI patients. Key words: Echocardiography; Myoeardial infarction; Atrial function,left

Effects of Levosimendan on Left Atrial Functions in Patients with Ischemic Heart Failure

With further progression of left ventricular (LV) dysfunction, the left atrial (LA) contribution to LV filling gradually decreases, and LA dysfunction deteriorates the decreased LV filling in patients with heart failure (HF). This study sought to investigate the effects of levosimendan on LA function in patients with HF. A total of 60 patients having acute decompensated HF with ischemic cardiomyopathy and LV ejection fraction (LVEF) < 40% were included in the study. Patients were randomized to levosimendan (n = 30) or to dobutamine (n = 30). Before and 24 h after treatment, LVEF, mitral inflow peak E and A wave velocity, E/A ratio, mitral lateral annulus peak Em wave velocity, E/Em ratio, LA volumes, and from the LA volumes the active emptying fraction (AEF), passive emptying fraction (PEF), and reservoir fraction (RF) were measured. All LA volumes were significantly reduced after levosimendan administration, but in the dobutamine group only minimal volume (Vmin) was reduced. Although AEF increased in both groups, the improvement of AEF was greater in the levosimendan group than in the dobutamine group (14% +/- 9% versus 2% +/- 1%, p = 0.001). The PEF (12% +/- 8% versus 21% +/- 6%, p = 0.04) and RF (23% +/- 4% versus 38% +/- 3%, p = 0.001) significantly increased after levosimendan administration, whereas these parameters did not change after dobutamine. In patients receiving levosimendan, there was a significant, positive correlation between PEF and Em (r = 0.475, p = 0.008), and there were significant negative correlations between PEF and E/Em (r = - 0.491, p = 0.006), and AEF and E/Em (r = - 0.654, p = 0.001). Left atrial functions respond better to levosimendan than to dobutamine in decompensated HF.