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Left Atrial Diameter (leave + atrial_diameter)
Selected AbstractsCorrelation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed TomographyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2009IRENE HOF M.D. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echocardiography, as an exclusion criterion for patients deemed candidates for ablation of AF. However, whether LAD accurately reflects true left atrial size has not been systematically investigated. Therefore, the purpose of this study was to test the hypothesis that LAD, measured by echocardiography, accurately correlates to left atrial volume measured by computed tomography (CT). Methods and Results: We included 50 patients (mean age 56 ± 12 years, five female) with symptomatic AF (40% paroxysmal, 60% persistent), referred for catheter ablation. In each patient, transthoracic echocardiography was performed. Additionally, all patients underwent CT using a 64-slice CT scanner. Left atrial volume was calculated by manually tracing left atrial area on each CT cross-sectional image. Patients had a mean LAD measured by echocardiography of 4.5 ± 0.7 cm, ranging from 2.9 to 5.7 cm. Left atrial volume measured by CT ranged from 67 mL to 270 mL with a mean value of 146 ± 49 mL. A poor correlation was noted between LAD and left atrial volume, r = 0.49 (P < 0.001). Conclusion: LAD measured by echocardiography correlates poorly with left atrial volume measured by CT in patients with AF. As a result, selecting patients with AF for treatment with catheter ablation should not be based on an echocardiographic-derived LAD alone. [source] Does Left Atrial Size Predict Mortality in Asymptomatic Patients with Severe Aortic Stenosis?ECHOCARDIOGRAPHY, Issue 2 2010Grace Casaclang-Verzosa M.D. Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS). Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler , 4 m/sec) followed for 5.4 ± 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function. Prediction of symptom development and mortality by left atrial diameter with and without adjusting for clinical and echocardiographic parameters was performed using Cox proportional-hazards regression analysis. Results: The age was 71 ± 11 years and 317 (62%) patients were males. The aortic valve mean gradient was 46 ± 11 mmHg, and the Doppler-derived aortic valve area was 0.9 ± 0.2 cm2. During follow-up, symptoms developed in 233 (45%), valve surgery was performed in 290 (57%) and 138 (27%) died. Left atrial enlargement was significantly correlated with symptom development (P < 0.05) but the association diminished after adjusting for aortic valve area and peak velocity (P = 0.2). However, atrial diameter predicted death independent of age and gender (P = 0.007), comorbid conditions (P = 0.03), and AS severity and Doppler parameters of diastolic function (P = 0.002). Conclusion: Diastolic function, represented as left atrial diameter, is related to mortality in asymptomatic patients with severe AS. (ECHOCARDIOGRAPHY 2010;27:105-109) [source] Mitral Valve Replacements in Redo Patients with Previous Mitral Valve Procedures: Mid-Term Results and Risk Factors for SurvivalJOURNAL OF CARDIAC SURGERY, Issue 5 2008Tankut Hakki Akay M.D. Patients and Methods: Between September 1989 and December 2003, 62 redo patients have undergone mitral valve replacements due to subsequent mitral valve problems. Preoperative, operative, and postoperative data were analyzed retrospectively and evaluated for risk factors affecting hospital mortality, mid- and long-term survival. Results: The hospital mortality was 6.4%. The one-, five-, and 10-year actuarial survival rates were 94%± 2%, 89%± 6%, and 81 ± 9%. New York Heart Association (NYHA) functional class IV, low left ventricular ejection fraction (<35%), increased left ventricular end-diastolic diameter (LVEDD) > 50 mm, female gender, pulmonary edema, and urgent operations were found to be risk factors in short-term survival. NYHA functional class IV, low left ventricular ejection fraction, increased LVEDD, and increased left atrial diameter (LA > 60 mm) were risk factors in mid-term survival. Conclusion: Redo mitral valve surgery with mechanical prosthesis offers encouraging short- and mid-term survival. NYHA functional class IV, low left ventricular ejection fraction, and increased left ventricular diameters were especially associated with increased short- and mid-term mortality. Earlier surgical management before the development of severe heart failure and myocardial dysfunction would improve the results of redo mitral valve surgery. [source] Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed TomographyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2009IRENE HOF M.D. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echocardiography, as an exclusion criterion for patients deemed candidates for ablation of AF. However, whether LAD accurately reflects true left atrial size has not been systematically investigated. Therefore, the purpose of this study was to test the hypothesis that LAD, measured by echocardiography, accurately correlates to left atrial volume measured by computed tomography (CT). Methods and Results: We included 50 patients (mean age 56 ± 12 years, five female) with symptomatic AF (40% paroxysmal, 60% persistent), referred for catheter ablation. In each patient, transthoracic echocardiography was performed. Additionally, all patients underwent CT using a 64-slice CT scanner. Left atrial volume was calculated by manually tracing left atrial area on each CT cross-sectional image. Patients had a mean LAD measured by echocardiography of 4.5 ± 0.7 cm, ranging from 2.9 to 5.7 cm. Left atrial volume measured by CT ranged from 67 mL to 270 mL with a mean value of 146 ± 49 mL. A poor correlation was noted between LAD and left atrial volume, r = 0.49 (P < 0.001). Conclusion: LAD measured by echocardiography correlates poorly with left atrial volume measured by CT in patients with AF. As a result, selecting patients with AF for treatment with catheter ablation should not be based on an echocardiographic-derived LAD alone. [source] Pulmonary Vein Morphology Before and After Segmental Isolation in Patients with Atrial FibrillationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2005MAREHIKO UEDA Background: The morphology of the pulmonary veins (PVs) before and after segmental isolation of the PVs has not been sufficiently characterized. Methods and Results: Multi-slice computed tomography was performed before and 3 ± 1 months after ablation in 30 patients with atrial fibrillation who underwent PV isolation. Before ablation, PV narrowing (,25% luminal reduction) was found in nine (8%) PVs. After ablation, de novo PV narrowing was found in 24 PVs (26%) and was detected only in the supero-inferior direction in 14 PVs (58%). The diameter reduction inside the PVs after ablation was greater in the supero-inferior direction (14 ± 12%) than in the antero-posterior direction (9 ± 13%; P < 0.0001). In the ablated PVs, the PV trunk was shorter than before ablation (P < 0.0001). The reduction in the diameters of both the PV ostium and the ablation site in the ablated PVs, as well as the diameter of the PV ostium in the nonablated PVs, correlated with the decrease in the left atrial diameter. Shortening of the PV trunk correlated with the severity of PV narrowing, but it was not related to the percent diameter reduction of the left atrium. PV narrowing before or after ablation did not result in any clinical consequences. Conclusions: PV narrowing is present in about 10% of PVs before ablation. Asymmetric luminal reduction and longitudinal shrinkage of the PV trunk occur after ablation. Reverse remodeling of the PV and contraction of the PV wall may contribute to the reduction in the PV diameter. PV morphology should be assessed with multi-directional views to avoid missing heterogeneous legions. [source] | ||||||||||