S B Goyal1, D H Spodick. 1. Cardiovascular Division, Department of Medicine, University of Massachusetts Medical School-St Vincent Hospital, Worcester, MA 01608, USA.
Abstract
OBJECTIVES: Our purpose was to determine the effect of interatrial block (IAB, P-wave duration >/=120 ms) on left atrial (LA) dynamics. IAB is associated with LA enlargement (LAE). LA dysfunction is associated with decreased left ventricular filling, a propensity for LA appendage thrombus formation, and reduced atrial natriuretic peptide levels. We evaluated LA function in patients with and without IAB matched for LA size. METHODS: Echocardiograms with LA enlargement were analyzed. Twenty-four patients had IAB, and 16 patients without IAB formed the control group. LA volumes, A-wave acceleration times (At), LA stroke volume (LASV), ejection fraction (LAEF), and kinetic energy (LAKE) were calculated. RESULTS: The control group and patients with IAB had comparable maximal LA volume and diameter (P >.05). Patients with IAB had significantly longer At (115 +/- 39 ms vs 83 +/- 24 ms, P <.01) and smaller LASV (7 +/- 5 mL vs 17 +/- 6 mL, P <.01), LAEF (9% +/- 6% vs 25% +/- 8%, P <.01), and LAKE (20 +/- 14 vs 65 +/- 44 Kdyne/cm/s, P <.01). LAKE varied inversely with P-wave duration (r = -0.51, P <.01). P-wave duration and minimal LA volume were independent determinants of LAEF. CONCLUSIONS: Patients with IAB have a sluggish, poorly contractile LA, and the extent of dysfunction is related to the degree of electrical delay from IAB. IAB should be considered a marker of an electromechanically dysfunctional LA and hence a risk factor for atrial fibrillation and congestive heart failure.
OBJECTIVES: Our purpose was to determine the effect of interatrial block (IAB, P-wave duration >/=120 ms) on left atrial (LA) dynamics. IAB is associated with LA enlargement (LAE). LA dysfunction is associated with decreased left ventricular filling, a propensity for LA appendage thrombus formation, and reduced atrial natriuretic peptide levels. We evaluated LA function in patients with and without IAB matched for LA size. METHODS: Echocardiograms with LA enlargement were analyzed. Twenty-four patients had IAB, and 16 patients without IAB formed the control group. LA volumes, A-wave acceleration times (At), LA stroke volume (LASV), ejection fraction (LAEF), and kinetic energy (LAKE) were calculated. RESULTS: The control group and patients with IAB had comparable maximal LA volume and diameter (P >.05). Patients with IAB had significantly longer At (115 +/- 39 ms vs 83 +/- 24 ms, P <.01) and smaller LASV (7 +/- 5 mL vs 17 +/- 6 mL, P <.01), LAEF (9% +/- 6% vs 25% +/- 8%, P <.01), and LAKE (20 +/- 14 vs 65 +/- 44 Kdyne/cm/s, P <.01). LAKE varied inversely with P-wave duration (r = -0.51, P <.01). P-wave duration and minimal LA volume were independent determinants of LAEF. CONCLUSIONS:Patients with IAB have a sluggish, poorly contractile LA, and the extent of dysfunction is related to the degree of electrical delay from IAB. IAB should be considered a marker of an electromechanically dysfunctional LA and hence a risk factor for atrial fibrillation and congestive heart failure.
Authors: Ankit Maheshwari; Faye L Norby; Elsayed Z Soliman; M Chadi Alraies; Selcuk Adabag; Wesley T O'Neal; Alvaro Alonso; Lin Y Chen Journal: Am J Cardiol Date: 2017-02-09 Impact factor: 2.778
Authors: Laxman Prajapat; Vignendra Ariyarajah; Mary E Frisella; Sirin Apiyasawat; David H Spodick Journal: Ann Noninvasive Electrocardiol Date: 2007-07 Impact factor: 1.468
Authors: Hooman Kamel; Wesley T O'Neal; Peter M Okin; Laura R Loehr; Alvaro Alonso; Elsayed Z Soliman Journal: Ann Neurol Date: 2015-08-31 Impact factor: 10.422
Authors: Ivan Hernandez-Betancor; Maria Manuela Izquierdo-Gomez; Javier Garcia-Niebla; Ignacio Laynez-Cerdena; Martin Jesus Garcia-Gonzalez; A Barragan-Acea; Jose Luis Irribarren-Sarria; Juan Jose Jimenez-Rivera; Juan Lacalzada-Almeida Journal: Curr Cardiol Rev Date: 2017
Authors: Fariha Sadiq Ali; Andres Enriquez; Diego Conde; Damian Redfearn; Kevin Michael; Christopher Simpson; Hoshiar Abdollah; Antoni Bayés de Luna; Wilma Hopman; Adrian Baranchuk Journal: Ann Noninvasive Electrocardiol Date: 2015-02-02 Impact factor: 1.468
Authors: Wesley T O'Neal; Hooman Kamel; Dawn Kleindorfer; Suzanne E Judd; George Howard; Virginia J Howard; Elsayed Z Soliman Journal: Neuroepidemiology Date: 2016-08-17 Impact factor: 3.282