Clinical InvestigationCongenital Heart DiseaseLeft Atrial Systolic Force in Children: Reference Values for Normal Children and Changes in Cardiovascular Disease With Left Ventricular Volume Overload or Pressure Overload
Section snippets
Patients
Of 230 prospectively studied subjects aged <18 years who were referred to our outpatient clinic for the evaluation of suspected electrocardiographic abnormalities, heart murmurs, or chest pain, 185 who were eventually confirmed to be normal and whose echocardiographic data were acceptable for analysis were enrolled in the present study to determine the reference values of LASF in children. Furthermore, changes in LASF associated with cardiovascular disease were studied in 71 consecutive
Age-Related Reference Values for LASF
Table 1 summarizes the demographic, hemodynamic, and echocardiographic characteristics of ventricular function and geometry of each group. The ages of normal subjects ranged from 10 days to 18 years. Figure 1 demonstrates the age-associated changes in LASF in normal children. LASF significantly increased with advancing age, with the regression equation given by 0.265 Ă— age (y) + 2.83 (r = 0.71, P < .001). There was no gender difference in this relationship (P = .86 for offset, P = .88 for
Discussion
The principal function of the left atrium is to modulate LV filling and thereby to modulate cardiovascular performance. This is accomplished through its well-defined actions as a booster pump during atrial systole and as a distensible reservoir and passive conduit for pulmonary venous flow during ventricular systole and early ventricular diastole, respectively.15 This study presents for the first time a reference value for developmental changes in LA booster pump function during childhood as
Limitations
As defined in the present study and previous reports, LASF represents an estimation of the force exerted by the contracting left atrium to accelerate blood into the left ventricle and should not be misinterpreted as an assessment of total atrial force. There are no valves between the incoming pulmonary veins and the left atrium, and atrial contraction leads a variable degree of transient pulmonary venous backflow. In patients with VSDs, the markedly increased pulmonary flow and thus pulmonary
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Evolution of left ventricular function in the preterm infant
2015, Journal of the American Society of EchocardiographyCitation Excerpt :With lower peak E, E/A ratio, peak e′, and e′/a′ ratio, as well as differences in early and late diastolic basal strain and SR compared with term infants, the preterm heart has impaired early filling and is more dependent on atrial contraction,19 a finding that is characteristic of the fetal heart.5,7,8 Although tachycardia may theoretically reduce Doppler indices of early filling and enhance late diastolic parameters, thus confounding interpretation,20 in both the present investigation and in a previous study of ventricular inflow Doppler parameters in preterm infants,21 no relationship between echocardiographic parameters and heart rate was observed. Furthermore, our use of tissue deformation SR parameters, which have less load dependence and are heart rate independent,22,23 provide additional support for our interpretation, findings that have not been previously reported in preterm infants.
Timing in resolution of left heart dilation according to the degree of mitral regurgitation in children with ventricular septal defect after surgical closure
2014, Jornal de PediatriaCitation Excerpt :It is known that left-to-right shunting in ventricular septal defects (VSD) generally increases pulmonary arterial blood flow and pulmonary venous return to the left heart. This pathophysiologic sequela may result in volume overload of the left atrium (LA) and left ventricle (LV), and subsequent LV enlargement, mitral annular dilation, mitral regurgitation (MR), and consequent LA enlargement to allow for the homeostatic balance of LA pressure.1–3 In the natural course of these changes after surgical closure, it has been demonstrated that the left ventricular end-diastolic volume (LVEDV) returns to normal within the first 2 years of life.
The assessment of atrial function in single ventricle hearts from birth to Fontan: A speckle-tracking study by using strain and strain rate
2013, Journal of the American Society of EchocardiographyCitation Excerpt :The SV atrial deformation parameters were also significantly altered compared with normal, with marked impairment of conduit strain, an increased reliance on active strain for ventricular filling, and reduced reservoir strain. The finding of reduced SV conduit function in early palliative stages also ran contrary to the expected increase observed in other congenital lesions with increased ventricular preload.17 Although increased SV atrial active strain in the early stages of surgical palliation may reflect the presence of increased volume load, its persistence in the later stages (when the preload is likely to have returned to normal levels) implies enhanced atrial contribution to ventricular filling.17
Pulmonary venous hypertension or pulmonary hypertension due to left heart disease
2009, Progress in Pediatric CardiologyArterial-left ventricular-left atrial coupling late after repair of aortic coarctation and interruption
2015, European Heart Journal Cardiovascular Imaging
This study was supported by national grant 8025127 from the Japan Society for the Promotion of Science to Dr Senzaki and medical research grants to Dr Senzaki from Nipro Corporation, the Kawano Memorial Foundation (H.S.), and Tenshindo Medical Institution (H.S.).