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JCU 1995 ;3(2) :121-129.
A Study on The Left Ventricular Diastolic Dysfunction in Ischemic Heart Disease -Influence of Left Ventricular Diastolic Dysfunction on Left Atrium-
Joon Woo Kim, Joo Han Kim, Sung Hee Kim, Jay Young Rhew, Youl Bae, Jeong Pyeong Seo, Gwang Chae Gill, Joo Hyung Park, Myung Ho Jeong, jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Division of Cardiology, Department of Intarnal Medicine, Chonnam University Medical School, Kwngju, Korea
Background : Diastolic dysfunction of left ventricle appears to be one of the earliest detectable abnormalities in a number of disorders. The aims of this study is to evaluate the influence of left ventricular diastolic dysfunction on left atrial function in patients with ischemic heart diseases. Method : Echocardiography, coronary and left ventricular(LV) angiography and LV catheterization were performed in 43 patients with ischemic heart disease to assess the influence of left ventricular(LV) diastolic dysfunction on left atrial function. They were divided to two groups by the absolute increase in left ventricular pressure during left atrial contraction(A amplitude ; Group I: ≥5mmHg, Group II : <5mmHg). Results : There were no significant difference in severity of coronary arterial lesions and Doppler echocardiographic parameters between the two groups. In M-mode echocardiography, Left atrial dimensions were measured at presystole(A1), early diastole(A2), and before and after left atrial contraction (A3, A4). In Graoup I, A1 was 37.3±5.1mm, A2 was 33.8±5.2mm, A3 was 34.4±5.5mm, and A4 was 29.3±50mm. In Group II,A1, 37.0±4.1mm, A2, 33.2±4.9mm, A3, 34.1±4.3mm, and A4, 28.5±4.6mm. The fractional shortening of early and late diastolic phase of left atrium[F1 = (A1-A2)/A1×100), F2 = ((A3-A4)/A3×100)] by the formula were 9.4±5.1%, 14.9±6.7% each, in Group I. In Group II, 12.1±7.3%, 20.6±10.2% each. F2 was higher in Group II(p<0.05). Left ventricular end diastolic pressure(LVEDP), LV pressure just before atrial contraction(Pre-A pressure) and absolute increase in left ventricular pressure during left atrial contraction(A amplitude) were more higher in group I(Group I : 18.4±7.9mmHg, 10.0±5.7mmHg, 10.3±4.4mmHg, Group II : 9.77±5.4mmHg, 6.5±4.1mmHg, 3.5±1.6mmHg, p<0.0005, p<0.05, p<0.0001). There was a good negative correlation between A amplitude and F2(r=-0.42, p<0.005). Conclusion : In patients wiht ischemic heart disease, LVEDP was higher and left ventricular ejection fraction and late diastolic fractional shortening of left atrium were lower in group with higher A amplitude. Thus, left atrial systolic function was reduced in proportion to left ventricular stiffness.
Keywords: Ischemic Heart disease, Left ventricular stiffness, Left atrial systolic function
Volume 25, No 4
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