Congestive Heart FailureIncreasing degrees of left ventricular filling impairment modulate left atrial function in humans
Section snippets
Patients
The study group consisted of 28 subjects in sinus rhythm with satisfactory transthoracic pulmonary venous and mitral valve flow velocity recordings, grouped according to 2 typical patterns of ventricular filling: impaired relaxation and restrictive pattern11 defined on the basis of the ratio between the Doppler peak of early to late diastolic mitral flow velocity (E/A) as well as the early mitral wave deceleration time (Tde) measured as the time interval from the E peak to the zero intercept of
Results
Clinical data from the 28 patients, along with the 9 normal subjects, are reported (Table I). At cardiac catheterization left ventricular end-diastolic pressure averaged 12.8 ± 4.6 mm Hg in the impaired relaxation group and 24.7 ± 5.6 mm Hg in the restrictive group (p <0.001).
Discussion
In the present study changes in left atrial mechanics and, in particular, in the reservoir, pump and conduit function of the atrium, are detailed in response to different degrees of left ventricular filling impairment. Our data confirm that increased atrial booster pump function, in response to an impaired ventricular relaxation, is obtained at the expense of increased cavity volume5; they also point to the potential influence that increased atrial afterload (i.e., ventricular end-diastolic
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