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European Journal of Echocardiography Advance Access published online on August 7, 2007
European Journal of Echocardiography, doi:10.1016/j.euje.2007.06.002
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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

The left atrial function index: a rhythm independent marker of atrial function

Liza Thomas1,*, Michelle Hoy2, Karen Byth2 and Nelson B. Schiller3

1 Department of Cardiology, University of Sydney, Westmead Hospital, Darcy Road, Sydney 2145, NSW, Australia
2 Westmead Hospital, Sydney, Australia
3 Department of Cardiology, UCSF, San Francisco, CA 94143-0214, USA

Received 28 May 2007; accepted after revision 2 June 2007.

* Corresponding author. Tel: +61 (02) 98456795; fax: +61 (02) 98458323. E-mail address: lizat{at}westgate.wh.usyd.edu.au (L. Thomas).


  Abstract

Aims: This study evaluates a simple echocardiographic rhythm independent expression of left atrial (LA) function, ‘the left atrial function index’ (LAFI).

Background: Quantitation of LA function is challenging and often established parameters including peak A are limited to sinus rhythm (SR). We hypothesized that atrial function could be characterized independent of rhythm by combining analogues of LA volume, reservoir function and LV stroke volume.

Methods: Seventy-two patients with chronic atrial fibrillation (CAF) were followed for six months post cardioversion (CV). Thirty-seven age matched healthy subjects were controls. The LAFI = LAEF x LVOT-VTI/LAESVI (LAEF = LA emptying fraction, LAESVI = maximal LA volume indexed to BSA, LVOT-VTI = outflow tract velocity time integral).

Results: The LAFI pre-CV in the CAF group was depressed vs controls (0.10 ± 0.05 vs 0.54 ± 0.17; P = 0.0001). Post-CV, LAFI was lower in persistent AF than in those restored to SR (AF vs SR: 0.08 ± 0.03 vs 0.15 ± 0.08; P = 0.0001), improved progressively in SR and was unchanged when AF persisted.

Conclusion: The LAFI, a simple, rhythm independent expression of atrial function, appears sensitive to differences between individuals in AF and those restored to SR and justifies clinical and investigative applications.

Keywords: Echocardiography; Atrial function; Atrial fibrillation


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