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Left atrial systolic force in asymptomatic aortic stenosis
Giovanni Cioffi1, Dana Cramariuc, Morten Dalsgaard
1Department of Cardiology, Villa Bianca Hospital, Trento, Italy. gcloffi@villablancatrento.i
Echocardiography (Mount Kisco, N.Y.)
|August 23, 2011
Summary
In patients with asymptomatic aortic stenosis (AS), left atrial (LA) systolic force (LASF) is linked to filling pressures. High LASF indicates LA effort to maintain LV filling, while low LASF suggests complex LA dysfunction or preload issues.
Area of Science:
- Cardiology
- Cardiac Physiology
- Echocardiography
Background:
- Limited understanding of left atrial (LA) systolic force (LASF) and its determinants in asymptomatic mild-moderate aortic stenosis (AS).
- Investigating the relationship between LASF and cardiac function in AS patients.
Purpose of the Study:
- To determine the key factors influencing LASF in patients with asymptomatic AS.
- To characterize patients with low and high LASF and their underlying mechanisms.
Main Methods:
- Utilized baseline data from 1,566 patients in the simvastatin ezetimibe in aortic stenosis study.
- Calculated LASF using Manning's method; defined low (<5th percentile) and high (>95th percentile) LASF.
- Analyzed demographic, clinical, and echocardiographic parameters to identify LASF determinants.
Main Results:
- Mean LASF was 21±14 kdynes/cm².
- LASF determinants included age, heart rate, BMI, systolic blood pressure, LV mass, mitral inflow velocity, LA volume, and deceleration time.
- High LASF correlated with abnormal LV relaxation (90%); low LASF associated with restrictive filling, normal LV relaxation, smaller LA volume, and lower BMI.
Conclusions:
- LASF is closely related to LV filling pressure in asymptomatic AS.
- High LASF reflects maximal LA effort to maintain normal LV filling.
- Low LASF represents a heterogeneous group with potential intrinsic LA dysfunction or low preload.
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