Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography
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Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography. / Olsen, Flemming Javier; Mogelvang, Rasmus; de Knegt, Martina Chantal; Galatius, Soren; Pedersen, Sune; Modin, Daniel; Ravnkilde, Kirstine; Gislason, Gunnar; Biering-Sorensen, Tor.
In: International Journal of Cardiovascular Imaging, Vol. 37, 2021, p. 3213–3221.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Left ventricular end-diastolic pressure is associated with left atrial functional measures by echocardiography
AU - Olsen, Flemming Javier
AU - Mogelvang, Rasmus
AU - de Knegt, Martina Chantal
AU - Galatius, Soren
AU - Pedersen, Sune
AU - Modin, Daniel
AU - Ravnkilde, Kirstine
AU - Gislason, Gunnar
AU - Biering-Sorensen, Tor
PY - 2021
Y1 - 2021
N2 - Echocardiography guidelines recommend the assessment of maximal LA volume (LAV(max)). Evidence, however, suggests additional value of functional LA measures. We investigated the association between functional LA measures and left ventricular end-diastolic pressure (LVEDP). Patients suspected of coronary artery disease referred for invasive coronary angiography (ICA) underwent, in addition to ICA, invasive pressure measurements. LVEDP > 12 mmHg was considered elevated. LA measurements by echocardiography included: LAV(max), minimal LA volume (LAV(min)), total LA emptying fraction (LAEF(total)), passive LA emptying fraction (LAEF(passive)), and active LA emptying fraction (LAEF(active)). Of 43 patients, 28 (65%) had elevated LVEDP. These patients more frequently had coronary vessel disease (VD) and impaired LA mechanics for all measures except LAV(max). All LA measures except LAV(max) were associated with LVEDP in unadjusted linear regression analyses. After adjustment for age and VD, only LA emptying fractions remained associated with LVEDP (2.6 (1.2-4.0) mmHg increase, p = 0.001, per 5% decrease in LAEF(total); 1.4 (0.1-2.8) mmHg increase, p = 0.040, per 5% decrease in LAEF(active); 1.8 (0.1-3.4) mmHg increase, p = 0.038, per 5% decrease in LAEF(passive)). In logistic regression, only LAEF(passive) was significantly associated with elevated LVEDP after adjusting for age and VD (OR = 1.11 (1.01-1.21), p = 0.023, per 1% decrease). Similar findings were made in subgroup analyses among patients without dilated LA and patients without conventional indicators of elevated filling pressure. Left ventricular end-diastolic pressure is significantly associated with LA functional measures but not LA volumes. Additionally, LAEF(passive) is associated with elevated LVEDP. Future studies examining LA function should include all components of LAEF.
AB - Echocardiography guidelines recommend the assessment of maximal LA volume (LAV(max)). Evidence, however, suggests additional value of functional LA measures. We investigated the association between functional LA measures and left ventricular end-diastolic pressure (LVEDP). Patients suspected of coronary artery disease referred for invasive coronary angiography (ICA) underwent, in addition to ICA, invasive pressure measurements. LVEDP > 12 mmHg was considered elevated. LA measurements by echocardiography included: LAV(max), minimal LA volume (LAV(min)), total LA emptying fraction (LAEF(total)), passive LA emptying fraction (LAEF(passive)), and active LA emptying fraction (LAEF(active)). Of 43 patients, 28 (65%) had elevated LVEDP. These patients more frequently had coronary vessel disease (VD) and impaired LA mechanics for all measures except LAV(max). All LA measures except LAV(max) were associated with LVEDP in unadjusted linear regression analyses. After adjustment for age and VD, only LA emptying fractions remained associated with LVEDP (2.6 (1.2-4.0) mmHg increase, p = 0.001, per 5% decrease in LAEF(total); 1.4 (0.1-2.8) mmHg increase, p = 0.040, per 5% decrease in LAEF(active); 1.8 (0.1-3.4) mmHg increase, p = 0.038, per 5% decrease in LAEF(passive)). In logistic regression, only LAEF(passive) was significantly associated with elevated LVEDP after adjusting for age and VD (OR = 1.11 (1.01-1.21), p = 0.023, per 1% decrease). Similar findings were made in subgroup analyses among patients without dilated LA and patients without conventional indicators of elevated filling pressure. Left ventricular end-diastolic pressure is significantly associated with LA functional measures but not LA volumes. Additionally, LAEF(passive) is associated with elevated LVEDP. Future studies examining LA function should include all components of LAEF.
KW - Left atrium
KW - Invasive
KW - Catheterization
KW - Filling pressure
KW - Echocardiography
KW - DOPPLER-ECHOCARDIOGRAPHY
KW - EUROPEAN ASSOCIATION
KW - EJECTION FRACTION
KW - AMERICAN SOCIETY
KW - RECOMMENDATIONS
KW - DISEASE
KW - UPDATE
KW - VOLUME
KW - SIZE
U2 - 10.1007/s10554-021-02300-5
DO - 10.1007/s10554-021-02300-5
M3 - Journal article
C2 - 34052974
VL - 37
SP - 3213
EP - 3221
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
ER -
ID: 272125486