The role of the left atrial appendage. A volume loading study in open-chest dogs.

Although the left atrial appendage has a quite unique structure, its function remains unclear. To clarify the function of the left atrial appendage, changes in its anteroposterior, transverse and longitudinal dimensions, and in the anteroposterior dimension of the left atrial body were measured by a sonomicrometer during volume loading in open chest dogs. In the control state, fractional shortening of the transverse dimension of the appendage was greater than that of the atrial body. After dextran infusion, each dimension of the appendage and body, measured just before atrial contraction, increased curvilinearly. The percent increase in appendage dimensions was greater than that of the atrial body dimension (p < 0.05). Systolic shortenings of the appendage increased until mean left atrial pressure reached approximately 15 mmHg but after further pressure elevation, it decreased. In postmortem isolated hearts, the appendage volume was 17.2 +/- 4.4% of the whole left atrial volume. These findings indicate that the appendage has a considerable volume with a greater compliance and assists left ventricular filling during atrial contraction by a Frank-Starling mechanism.