Relationship between left ventricular wall thickness and left atrial size: comparison with other measures of diastolic function.
Relationship between left ventricular wall thickness and left atrial size: comparison with other measures of diastolic function.
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DOI：
10.1016/s0894-7317(05)80356-6
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发表时间：
1995-01-01
期刊：
影响因子：
--
通讯作者：
Kaul, S
中科院分区：
文献类型：
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作者：
Simek, C L;Feldman, M D;Kaul, S
我们假设，在原发性高血压和左心室（LV）收缩功能正常的患者中，左心房（LA）大小与左心室壁厚度相关，比常用的左心室舒张功能的血流动力学和多普勒测量更好地反映左心室高血压的慢性性和持续时间。因此，对 30 名除原发性高血压（平均收缩压为 150 +/- 29 mm Hg）之外没有心血管异常的受试者进行了血流动力学、多普勒和二维超声心动图测量。平均左心室壁厚度为 0.57 +/- 0.14 cm/m2，平均左心室射血分数为 0.62 +/- 0.12。血流动力学和多普勒测量，包括肺毛细血管楔和左室舒张末压、等容左室压力松弛、左室弹性刚度和 E/A 比（二尖瓣脉冲多普勒信号上的 E 波和 A 波）与左室壁厚度相关性较差（r = 0.01 至 -0.52）。 E/A 比值和等容左心室压力舒张与患者年龄的相关性优于与左室壁厚度的相关性 (p = 0.05)。相反，LA 面积（心尖四腔切面）与 LV 壁厚度具有良好的相关性（心房舒张期 LA 面积 r = 0.77，心房收缩期 LA 面积 r = 0.86）。多元回归分析显示心房收缩时的左心室面积是左心室壁厚度的最佳相关性。我们的结论是，由于左心房是薄壁结构，其尺寸可能会随着 LA 压力的增加而增加。在没有二尖瓣疾病和心房颤动的情况下，LA 大小可能反映 LA 高血压的慢性性和持续时间，从而反映 LA 高血压病史。因此，心尖四腔切面中的左心室大小可以为左心室舒张功能障碍的程度提供简单的无创评估。
We postulated that in patients with essential hypertension and normal left ventricular (LV) systolic function, left atrial (LA) size correlates with LV wall thickness by better reflecting the chronicity and duration of LA hypertension than the commonly used hemodynamic and Doppler measures of LV diastolic function. Accordingly, hemodynamic, Doppler, and two-dimensional echocardiographic measurements were performed in 30 subjects with no cardiovascular abnormalities other than essential hypertension (mean systolic blood pressure of 150 +/- 29 mm Hg). The mean LV wall thickness was 0.57 +/- 0.14 cm/m2 and the mean LV ejection fraction was 0.62 +/- 0.12. Hemodynamic and Doppler measures including pulmonary capillary wedge and LV end-diastolic pressures, isovolumic LV pressure relaxation, LV chamber elastic stiffness, and E/A ratio (E and A waves on the pulsed Doppler signal of the mitral valve) correlated poorly (r = 0.01 to -0.52) with LV wall thickness. Both E/A ratio and isovolumic LV pressure relaxation correlated better (p = 0.05) with patient age than with LV wall thickness. In contrast, LA area (in the apical four-chamber view) had a good correlation (r = 0.77 for LA area in atrial diastole and r = 0.86 for LA area in atrial systole) with LV wall thickness. Multiple regression analysis revealed LA area in atrial systole to be the best correlate of LV wall thickness. We conclude that because the left atrium is a thin-walled structure, its size may increase with an increase in LA pressure. In the absence of mitral valve disease and atrial fibrillation, LA size may reflect the chronicity and duration and thus the history of LA hypertension. LA size in the apical four-chamber view may, therefore, provide a simple noninvasive assessment of the degree of LV diastolic dysfunction.