Advertisement

Pediatric Cardiology

, Volume 34, Issue 1, pp 105–111 | Cite as

Left Atrial Volume Change Throughout the Cardiac Cycle in Children With Congenital Heart Disease Associated With Increased Pulmonary Blood Flow: Evaluation Using a Novel Left Atrium-Tracking Method

  • Miho SakataEmail author
  • Yasunobu Hayabuchi
  • Miki Inoue
  • Tatsuya Onishi
  • Shoji Kagami
Original Article

Abstract

There is a paucity of data regarding the significance of left atrial (LA) volume and its changes throughout the cardiac cycle in pediatric patients with heart disease. The recently developed LA volume-tracking (LAVT) method can automatically construct the LA volume curve. The study group consisted of 48 pediatric patients with ventricular septal defect (n = 34) or patent ductus arteriosus (n = 14) and age-matched healthy controls. Maximum and minimum LA volumes (LAVmax and LAVmin, respectively) were measured. The total LA emptying volume (LAVtotal) was defined as LAVmax − LAVmin. Volume parameters were standardized by dividing by body surface area (BSA). The total LA emptying fraction (%LAVtotal) was defined as the ratio of LAVtotal to LAVmax. In the patient group, there was a positive correlation between the ratio of pulmonary to systemic blood flow (Qp/Qs) and LAVmax/BSA, LAVmin/BSA, and LAVtotal/BSA (r = 0.42, 0.44, and 0.34, respectively). LAVmin/BSA was positively correlated with the ratio of early mitral inflow velocity to early mitral annular diastolic tissue Doppler velocity (E/E′) (r = 0.32). The %LAVtotal had a negative correlation with left-ventricular (LV) end-diastolic pressure (r = −0.32). There were significant correlations between serum B-type natriuretic peptide level and LAVmax/BSA, LAVmin/BSA, and %LAVtotal (r = 0.38, 0.49, and −0.35, respectively). The LAVT method is useful in the evaluation of LV diastolic function in pediatric patients with chronic LV volume overload.

Keywords

Children Congenital heart disease Left atrium-tracking method Left atrium volume change 

References

  1. 1.
    Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ et al (2006) Left atrial size. J Am Coll Cardiol 47:2357–2363PubMedCrossRefGoogle Scholar
  2. 2.
    Anwar AM, Soliman OII, Geleijnse ML, Nemes A, Vletter WB, ten Cate FJ (2008) Assessment of left atrial volume and function by real-time three-dimensional echocardiography. Int J Cardiol 123:155–161PubMedCrossRefGoogle Scholar
  3. 3.
    Aurigemma GP, Gottdiener JS, Arnold AM, Chinali M, Hill JC, Kitzman D (2009) Left atrial volume and geometry in healthy aging: the cardiovascular health study. Circ Cardiovasc Imaging 2:282–289PubMedCrossRefGoogle Scholar
  4. 4.
    Barclay JL, Kruszewski K, Croal BL, Cuthbertson BH, Oh JK, Hillis GS (2006) Relation of left atrial volume to B-type natriuretic peptide levels in patients with stable chronic heart failure. Am J Cardiol 98:98–101PubMedCrossRefGoogle Scholar
  5. 5.
    Bursi F, Weston SA, Redfield MM, Jacobsen SJ, Pakhomov S, Nkomo VT et al (2006) Systolic and diastolic heart failure in the community. JAMA 296:2209–2216PubMedCrossRefGoogle Scholar
  6. 6.
    Keller AM, Gopal AS, King DL (2000) Left and right atrial volume by freehand three-dimensional echocardiography: in vivo validation using magnetic resonance imaging. Eur J Echocardiogr 1:55–65PubMedCrossRefGoogle Scholar
  7. 7.
    Koch A, Zink S, Singer H (2006) B-type natriuretic peptide in paediatric patients with congenital heart disease. Eur Heart J 26:861–866CrossRefGoogle Scholar
  8. 8.
    Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108PubMedCrossRefGoogle Scholar
  9. 9.
    Lim TK, Ashrafian H, Dwivedi G, Collinson PO, Senior R (2006) Increased left atrial volume index is an independent predictor of raised serum natriuretic peptide in patients with suspected heart failure but normal left ventricular ejection fraction: Implication for diagnosis of diastolic heart failure. Eur J Heart Fail 8:38–45PubMedCrossRefGoogle Scholar
  10. 10.
    Menon SC, Ackerman MJ, Cetta F, O’Leary PW, Eidem BW (2008) Significance of left atrial volume in patients <20 years of age with hypertrophic cardiomyopathy. Am J Cardiol 102:1390–1393PubMedCrossRefGoogle Scholar
  11. 11.
    Murata M, Wanaka S, Tamura Y, Kondo M, Okayama K, Murata M et al (2008) A real-time three-dimensional echocardiographic quantitative analysis of left atrial function in left ventricular diastolic dysfunction. Am J Cardiol 102:1097–1102PubMedCrossRefGoogle Scholar
  12. 12.
    Ogawa K, Hozumi T, Sugioka K, Iwata S, Otsuka R, Takagi Y et al (2009) Automated assessment of left atrial function from time-left atrial volume curves using a novel speckle tracking imaging method. J Am Soc Echocardiogr 22:63–69PubMedCrossRefGoogle Scholar
  13. 13.
    Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S et al (2009) Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 22:70–75PubMedCrossRefGoogle Scholar
  14. 14.
    Otani K, Takeuchi M, Kaku K, Haruki N, Yoshitani H, Tamura M et al (2010) Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 23:961–967PubMedCrossRefGoogle Scholar
  15. 15.
    Oyamada J, Toyono M, Shimada S, Aoki-Okazaki M, Tamura M, Takahashi T et al (2008) Noninvasive estimation of left ventricular end-diastolic pressure using tissue Doppler imaging combined with pulsed-wave Doppler echocardiography in patients with ventricular septal defects: a comparison with the plasma levels of the B-type natriuretic peptide. Echocardiography 25:270–277PubMedCrossRefGoogle Scholar
  16. 16.
    Paul MA, Backer CL, Binns HJ, Mavroudis C, Webb CL, Yogev R et al (2009) B-type natriuretic peptide and heart failure in patients with ventricular septal defect: a pilot study. Pediatr Cardiol 30:1094–1097PubMedCrossRefGoogle Scholar
  17. 17.
    Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Pacemakers FE et al (2007) How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the heart failure and echocardiography associations of the European society of cardiology. Euro Heart J 28:2539–2550CrossRefGoogle Scholar
  18. 18.
    Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ (2003) Burden of systolic and diastolic ventricular dysfunction in the community. JAMA 289:194–202PubMedCrossRefGoogle Scholar
  19. 19.
    Senzaki H, Kumakura R, Ishido H, Masutani S, Seki M, Yoshida S (2009) Left atrial systolic force in children: reference values for normal children and changes in cardiovascular disease with left ventricular volume overload or pressure overload. J Am Soc Echocardiogr 22:939–946PubMedCrossRefGoogle Scholar
  20. 20.
    Ueda Y, Fukushige J, Ueda K (1996) Congestive heart failure during early infancy in patients with ventricular septal defect relative to early closure. Pediatr Cardiol 17:382–386PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Miho Sakata
    • 1
    Email author
  • Yasunobu Hayabuchi
    • 1
  • Miki Inoue
    • 1
  • Tatsuya Onishi
    • 1
  • Shoji Kagami
    • 1
  1. 1.Department of Pediatrics, School of MedicineUniversity of TokushimaTokushimaJapan

Personalised recommendations