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Left Atrial Volume Index as Indicator of Left Ventricular Diastolic Dysfunction: Comparation between Left Atrial
Fulvio Cacciapuoti1, Anna Scognamiglio, Venere Delli Paoli
1Echocardiographic Laboratory, Department of Internal Medicine and Geriatry, Second University of Naples, Naples, Italy.
Insights
Left atrial volume index (LAVI) and left ventricular (LV) diastolic intervals effectively identify LV diastolic dysfunction in hypertensive patients. These echocardiographic measures offer reliable non-invasive assessment for systemic hypertension.
Area of Science:
- Cardiology
- Echocardiography
- Diastolic Function
Background:
- Left ventricular (LV) diastolic dysfunction is a key complication of systemic hypertension.
- Assessing diastolic dysfunction non-invasively is crucial for patient management.
- Left atrial volume index (LAVI) and LV diastolic time intervals are potential markers.
Purpose of the Study:
- To investigate the correlation between LAVI and LV diastolic time intervals.
- To evaluate the utility of these parameters in defining LV diastolic dysfunction in hypertensive patients.
- To establish reference values in healthy controls.
Main Methods:
- Two-dimensional echocardiography and tissue Doppler echocardiography (TDE) were used in 62 hypertensive patients and 15 controls.
- Measurements included LV volumes, myocardial mass index, ejection fraction (EF%), LAVI, myocardial performance index (MPI), and diastolic time intervals (IVCT, IVRT, ejection time).
Main Results:
- Hypertensive patients showed significantly increased LV volumes and mass index compared to controls.
- LAVI was elevated in hypertensive patients with left ventricular hypertrophy.
- Iso-volumetric relaxation time (IVRT) was significantly prolonged, and MPI was higher in hypertensive patients, indicating diastolic dysfunction.
Conclusions:
- LAVI, MPI, and their time intervals are reliable non-invasive tools for diagnosing LV diastolic dysfunction.
- These echocardiographic parameters are valuable in systemic hypertension, particularly when mitral valve disease is absent.
Background:
To point out a possible correlation between left atrial volume index (LAVI) and left ventricular (LV) diastolic time interval to better define LV diastolic dysfunction, this study was performed.
Methods:
In 62 hypertensive-hypertrophic patients without LV systolic dysfunction, LV volumes, myocardial mass index, ejection fraction% (EF%) and LAVI were measured by two-dimensional echocardiography. Instead, tissue Doppler echocardiography (TDE) was used to measure myocardial performance index (MPI) and its systo-diastolic time intervals, such as: iso-volumetric contraction time (IVCT); iso-volumetric relaxation time (IVRT); ejection time. LAVI, TDE-MPI and time intervals where also measured in 15 healthy controls, to obtain the reference values.
Results:
Results shown a significant increase of LV volumes in hypertensives in comparison to the control group (p < 0.05). LV mass index also augmented (p < 0.001). Instead, EF% not significantly changed in hypertrophic patients in comparison with healthy controls. LAVI raised in hypertensives wih left ventricular hypertrophy, whereas IVCT resulted within the normal limits. On the contrary, IVRT significantly raised. Accordingly, MPI resulted higher in controls.
Conclusion:
LAVI, MPI and its time intervals appear as reliable tools to non-invasively individualize LV diastolic dysfunction in systemic hypertension, in absence of mitral valve disease.
