Echocardiographic Correlation between Right Ventricular Function and Left Atrial Volume

Abstract Background: Few reports exist on the relationship of the left ventricular diastolic dysfunction (LVDD) with its most important features including enlargement of the left atrium and left ventricular hypertrophy (LVH), and with the right ventricular (RV) function. Objective: To determine the correlation between the left atrial size and the RV function and dimensions in patients with and without LVDD and LVH. Methods: Fifty patients were included, 25 (40% men) of them with LVDD, aged 67.1 ± 10.6 years (study group) and 25 without LVDD (52% men) aged 49.9 ± 16.3 years (control group). Patients underwent transthoracic echocardiography with evaluation of the left atrial size and volume (LAV), LVDD, LVH, and RV function and dimensions. P-values 34 mL/m2 and left atrial size > 40 mm were associated with lower absolute values of tricuspid annular plane systolic excursion (TAPSE) and RV lateral S' (p ≤ 0.001, Pearson's correlation coefficient -0.4 and -0.38, respectively) in the study group. Patients in the study group showed higher incidence of LVH (p = 0.02) and greater left atrial diameter (p = 0.03) compared with the control group. In addition, greater left atrial diameter (p = 0.02) and LAV (p = 0.01) values were found in patients with LVDD grade II compared with LVDD grade I. Conclusions: The present study determined, for the first time, the correlation of left atrial enlargement with progressive RV dysfunction in patients with LVDD.

摘要 背景：目前关于左心室舒张功能障碍（left ventricular diastolic dysfunction, LVDD）与其核心特征——包括左心房扩大与左心室肥厚（left ventricular hypertrophy, LVH）——以及右心室（right ventricular, RV）功能之间关联的报道较为匮乏。目的：明确存在与不存在左心室舒张功能障碍及左心室肥厚的患者中，左心房大小与右心室功能及结构径线的相关性。方法：本研究共纳入50例患者，其中25例为左心室舒张功能障碍组（研究组），男性占比40%，年龄为67.1±10.6岁；剩余25例为非左心室舒张功能障碍对照组，男性占比52%，年龄为49.9±16.3岁。所有受试者均接受经胸超声心动图检查，评估左心房大小与容积（left atrial size and volume, LAV）、左心室舒张功能障碍、左心室肥厚以及右心室功能与结构径线。研究组中，当左心房容积＞34 mL/m²且左心房内径＞40 mm时，患者的三尖瓣环收缩期位移（tricuspid annular plane systolic excursion, TAPSE）与右心室侧壁收缩期峰值速度（RV lateral S'）的绝对值更低（P≤0.001，皮尔逊相关系数分别为-0.4与-0.38）。与对照组相比，研究组患者的左心室肥厚发生率更高（P=0.02），左心房内径更大（P=0.03）。此外，与左心室舒张功能障碍I级患者相比，左心室舒张功能障碍II级患者的左心房内径（P=0.02）与左心房容积（P=0.01）均显著更高。结论：本研究首次明确了左心室舒张功能障碍患者中，左心房扩大与进行性右心室功能障碍之间的相关性。