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Titolo:
Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function
Autore:
Barbier, P; Solomon, SB; Schiller, NB; Glantz, SA;
Indirizzi:
Univ Calif San Francisco, Div Cardiol, Inst Cardiovasc Res, San Francisco,CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 rancisco,CA 94143 USA Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA Univ CalifSan Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Milan, Ist Cardiol, CNR, IRCCS,Fdn Monzino, I-20138 Milan, Italy UnivMilan Milan Italy I-20138 , IRCCS,Fdn Monzino, I-20138 Milan, Italy
Titolo Testata:
CIRCULATION
fascicolo: 4, volume: 100, anno: 1999,
pagine: 427 - 436
SICI:
0009-7322(19990727)100:4<427:LARALV>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
PULMONARY VENOUS FLOW; CONTRACTILE PERFORMANCE; CONSCIOUS DOGS; HEART-FAILURE; ECHOCARDIOGRAPHY; ADAPTATION;
Keywords:
hemodynamics; mechanics; atrium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Glantz, SA Univ Calif San Francisco, Div Cardiol, Inst Cardiovasc Res, SanFrancisco,CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 94143 USA
Citazione:
P. Barbier et al., "Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function", CIRCULATION, 100(4), 1999, pp. 427-436

Abstract

Background-Determinants of left atrial (LA) reservoir function and its influence on left ventricular (LV) function have not been quantified. Methods and Results-In an open-pericardium, paced (70 and 90 bpm) pig model of LV regional ischemia (left anterior descending coronary constriction),with high-fidelity LV, LA, and RV pressure recordings, we obtained the LA area with 2D automated border detection echocardiography, LA pressure-area loops, and Doppler transmitral flow. We calculated LV tau, LA relaxation (a-x pressure difference divided by time, normalized by a pressure), and stiffness (slope between x and v pressure points of v loop). Determinants of total LA reservoir (maximum-minimum area, cm(2)) were identified by multiple regression analysis. Different mean rates of LA area increase identified 2 consecutive (early rapid and late slow) reservoir phases. During ischemia, LV long-axis shortening (LAS, LV base systolic descent) and LA reservoir area change decreased (7.3+/-0.3 [SEM] versus 5.6+/-0.3 cm(2), P<0.001) and LA stiffness increased (1.6+/-0.3 versus 3.1+/-0.3 mm Hg/cm(2), P=0.009). Early reservoir area change depended on LA mean ejection rate (LA area at ECGP wave minus minimum area divided by time; multiple regression coefficient=0.9; P<0.001) and relaxation (coefficient=4.9 cm(2)xms/s; P<0.001). Late reservoir area change depended on LAS (coefficient=8 cm/s; P<0.001), Total reservoir filling depended on LA stiffness (coefficient=-0.31 cm(4)/mmHg; P=0.001) and cardiac output (coefficient=0.001 cm(2)xmin/L; P=0.002), The strongest predictor of cardiac output was LA reservoir filling (coefficient=301 L/minxcm(2); P<0.001). The v loop area was determined by cardiac output, LV ejection time, tau, and early transmitral flow. Conclusions-Two (early and late) reservoir phases are determined by LA contraction and relaxation and LV base descent. Acute LV regional ischemia increases LA stiffness and impairs LA reservoir function by reducing LV base descent.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/10/20 alle ore 16:00:08