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European Journal of Echocardiography Advance Access published online on September 11, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen234
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Value of assessment of left atrial volume and diameter in patients with heart failure but with normal left ventricular ejection fraction and mitral flow velocity pattern

Chikako Yoshida, Shinji Nakao, Akiko Goda, Yoshiro Naito, Mika Matsumoto, Misato Otsuka, Miho Shimoshikiryo{dagger}, Akiyo Eguchi, Masaaki Lee-Kawabata, Takeshi Tsujino and Tohru Masuyama*

Cardiovascular Division, Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan

Received 11 May 2008; accepted after revision 23 August 2008.

* Corresponding author. Tel: +81 798 45 6553; fax: +81 798 45 6551. E-mail address: masuyama{at}hyo-med.ac.jp


  Abstract

Aims: We assessed the comparative value of measurements of tissue Doppler early diastolic mitral annular velocity (E'), left atrial diameter (LAD), and left atrial volume (LAV) in patients with possible heart failure (HF) but with normal left ventricular (LV) ejection fraction (EF) and mitral flow velocity pattern.

Methods and results: We determined LAV and LAD indexes in addition to the ratio of peak early diastolic mitral flow velocity (E) to E' (E/E' ratio) in 91 patients with all three of the followings: HF, LVEF of greater than 55%, and normal mitral E/A ratio between 0.8 and 1.5. Twenty healthy subjects were used as controls. E/E' ratio was abnormal (>1.5) in 38 of the 91 patients (sensitivity=44%). LAV index was 32 mL/m2 or greater in 71 of the 91 patients (sensitivity=78%), while LAD index was 27 mm/m2 or greater in 81 of 91 patients (sensitivity=89%). The area under the curve by receiver–operator curve analyses was 0.995 for LA volume index, 0.998 for LAD index, and 0.885 for E/E' ratio.

Conclusion: LAV and LAD indexes are more useful in detecting with HF and normal EF patients than E' related parameters.

Keywords: Left atrium volume; Mitral flow; E/E'; Diastole; Heart failure

{dagger} Present address. Department of Internal Medicine, Kobe University, Kobe, Japan.


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