Interv Akut Kardiol. 2013;12(2):79-82

The importance of left atrial anatomy and function for prognosis and interventional therapy

Libor Škňouřil, Martin Fiala
Oddělení kardiologie, Nemocnice Podlesí a.s., Třinec

With the development of invasive procedures, the view of the left atrium has been changed. Left atrial dilatation and dysfunction used to

be considered permanent, but it has been shown that the pathological remodelation can be reversible. The number of invasive procedures

where the left atrium is their place or target is increasing. Most of this procedures is connected with atrial fibrillation. This article deals

with the anatomy and function of the left atrium that is important for interventional procedures as well as for their optimal indication.

Keywords: left atrium, remodelation, atrial fibrillation, interventional therapy

Published: March 1, 2013  Show citation

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Škňouřil L, Fiala M. The importance of left atrial anatomy and function for prognosis and interventional therapy. Interv Akut Kardiol. 2013;12(2):79-82.
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    References

    1. Januška J, Branny M, Fiala M, et al. A new technique of catheter mitral paravalvular leak closure. Interv Akut Cardiol 2011; 10: 54-56.
    2. Recommendations for Chamber Quantification: A report from the American society of echocardiography's guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European society of cardiology. J Am Soc Echocardiogr 2005; 18: 1440-1463. Go to original source... Go to PubMed...
    3. Ho SY, Sanchez-Quintana D, Cabrera JA, Anderson RH. Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 1999; 10(11): 1525-1533. Go to original source...
    4. Wang K, Ho SY, Gibson DG, Anderson RH. Architecture of atrial musculature in humans. Br Heart J 1995; 73: 559-565. Go to original source... Go to PubMed...
    5. Mitchell JH, Shapiro W. Atrial function and the hemodynamic consequences of atrial fibrillation in man. Am J Cardiol 1969; 23: 556-567. Go to original source... Go to PubMed...
    6. Appleton CP, Hatle LK, Popp RL. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 1988; 12: 426-440. Go to original source... Go to PubMed...
    7. Ho SY, Anderson RH, Sanchez-Quintana D. Atrial structure and fibres: morphologic bases of atrial conduction. Cardiovascular Research 2002; 54: 325-336. Go to original source... Go to PubMed...
    8. Fiala M, Chovančík J, Heinc P, et al. Léčba symptomatické intermitentní fibrilace síní katetrovou ablací v levé srdeční síni. Bezprostřední a dlouhodobé výsledky u 150 pacientů. Vnitř Lék 2005; 51: 971-983.
    9. Goldman ME, Pearce LA, Hart RG, et al. Pathophysiologic correlates of thromboembolism in nonvalvular atrial fibrillation: I. Reduced flow velocity in the left atrial appendage (The Stroke Prevention in Atrial Fibrillation/SPAFF-III/study). J Am Soc Echocardiogr 1999; 12: 1080-1087. Go to original source... Go to PubMed...
    10. Fatkin D, Kelly RP, Feneley MP. Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol 1998; 23(4): 961-969. Go to original source... Go to PubMed...
    11. Platonov PG, Ivanov V, Ho SY, Mitrofanova L. Left atrial posterior wall thickness in patients with and without atrial fibrillation: data from 298 consecutive autopsies. J Cardiovasc Electrophysiol. 2008; 19(7): 689-692. Go to original source... Go to PubMed...
    12. Vyas H, Jackson K, Chenzbraun A. Switching to volumetric left atrial measurements: impact on routine echocardiographic practise. Eur J Echocardiogr 2012; 12: 107-111. Go to original source... Go to PubMed...
    13. Koka AR, Yau J, Van Why C, et al. Underestimation of left atrial size measured with transthoracic echocardiopgraphy compared with 3D MDCT. Am J Roentgenol. 2010; 194(5): 375-381. Go to original source... Go to PubMed...
    14. Rodevan O, Bjornerheim R, Ljosland M, et al. Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. Int J Card Imaging 1999; 15: 397-410. Go to original source... Go to PubMed...
    15. Choong CY, Herrmann HC, Weyman AE, Fifer MA. Preload dependence of Doppler-derived indexes of left ventricular diastolic function in humans. J Am Coll Cardiol 1987; 10: 800-808. Go to original source... Go to PubMed...
    16. Pritchett AM, Mahoney DW, Jacobsen SJ, et al. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol 2005; 45: 87-92. Go to original source... Go to PubMed...
    17. Sanfilippo AJ, Abascal VM, Sheehan M, et al. Atrial enlagement as a consequence of atrial fibrillation. A prospective echocardiographic study. Circulation 1990; 82: 792-797. Go to original source... Go to PubMed...
    18. Tavi P, Han C, Weckstrom M. Mechanisms of stretch-induced changes in [Ca2+] i in rat atrial myocytes: role of increased troponin C affinity and stretch-activated ion channels. Circ Res 1998; 83: 1165-1177. Go to original source... Go to PubMed...
    19. Nistri S, Galderisi M, Ballo P, et al. Determinants of echocardiographic left atrial volume: implications for normalcy. Eur J Echocardiogr 2011; 12: 826-833. Go to original source... Go to PubMed...
    20. Blondheim DS, Osipov A, Meisel SR, et al. Relation of left atrial size to function as determined by transesophageal echocardiography. Am J Cardiol. 2005; 96(3): 457-463. Go to original source... Go to PubMed...
    21. Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997; 96(4): 1180-1184. Go to original source... Go to PubMed...
    22. Aime-Sempe CH, Folliguet T, Ru¨cker-Martin C, et al. Myocardial cell death in fibrillating and dilated human right atria. J Am Coll Cardiol 1999; 34: 1577-1586. Go to original source... Go to PubMed...
    23. Hoit BD, Shao Y, Gabel M, Walsh RA. Left atrial mechanical and biochemical adaptation to pacing induced heart failure. Cardiovasc Res 1995; 29: 469-474. Go to original source... Go to PubMed...
    24. Ausma J, Coumans WA, Duimel H, et al. Atrial high energy phosphate content and mitochondrial enzyme activity during chronic atrial fibrillation. Cardiovasc Res 2000; 47: 788-796. Go to original source... Go to PubMed...
    25. Morillo CA, Klein GJ, Jones DL, Guiraudon CM. Chronic rapid atrial pacing. Structural, functional, and electrophysiogical characteristics of a new model of sustained atrial fibrillation. Circulation 1995; 91: 1588-1595. Go to original source... Go to PubMed...
    26. Solti F, Vecsey T, Kekesi V, Juhasz-Nagy A. The effect of atrial dilatation on the genesis of atrial arrhythmias. Cardiovasc Res 1989; 23: 882-886. Go to original source... Go to PubMed...
    27. Kannel WB, Wolf PA, Benjamin EJ, et al. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998; 82(Suppl. 8A): 2N-9N. Go to original source... Go to PubMed...
    28. Franco V, Chen YF, Oparil S, et al. Atrial natriuretic peptide dose-dependently inhibits pressure overload-induced cardiac remodeling. Hypertension 2004; 44(5): 746-750. Go to original source... Go to PubMed...
    29. Dietz JR. Mechanisms of atrial natriuretic peptide secretion from the atrium. Cardiovasc Res 2005;68 (1): 8-17. Go to original source... Go to PubMed...
    30. Tsioufis C, Stougiannos P, Taxiarchou E, et al. The interplay between haemodynamic load, brain natriuretic peptide and left atrial size in the early stages of essential hypertension. J Hypertens 2006; 24: 965-972. Go to original source... Go to PubMed...
    31. Schneider MP, Hua TA, Böhm M, et al. Prevention of atrial fibrillation by Renin-Angiotensin system inhibition a meta-analysis. J Am Coll Cardiol 2010; 55(21): 2299-2307. Go to original source... Go to PubMed...
    32. Tsang TS, Barnes ME, Abhayaratna WP, et al. Effects of quinapril on left atrial structural remodeling and arterial stiffness. Am J Cardiol 2006; 97(6): 916-920. Go to original source... Go to PubMed...
    33. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104(24): 2886-2891. Go to original source... Go to PubMed...
    34. Psychari SN, Apostolou TS, Sinos L, et al. Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation. Am J Cardiol 2005; 95(6): 764-767. Go to original source... Go to PubMed...
    35. Tsang TS, Barnes ME, Gersh BJ, et al. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 2002; 90(12): 1284-1289. Go to original source... Go to PubMed...
    36. Pritchett AM, Mahoney DW, Jacobsen SJ, et al. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol 2005; 45(1): 87-92. Go to original source... Go to PubMed...
    37. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol 2003; 42(7): 1206-1207. Go to original source... Go to PubMed...
    38. Takemoto Y, Barnes ME, Seward JB, et al. Usefulness of left atrial volume in predicting first congestive heart failure in patients > or = 65 years of age with well-preserved left ventricular systolic function. Am J Cardiol 2005; 96: 832-836. Go to original source... Go to PubMed...
    39. Beinart R, Boyko V, Schwammenthal E, et al. Long-term prognostic significance of left atrial volume in acute myocardial infarction. J Am Coll Cardiol. 2004; 44(2): 327-334. Go to original source... Go to PubMed...
    40. Rossi A, Cicoira M, Zanolla L, et al. Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2002; 40(8): 1425. Go to original source... Go to PubMed...
    41. Nistri S, Olivotto I, Betocchi S, et al. Prognostic significance of left atrial size in patients with hypertrophic cardiomyopathy (from the Italian Registry for Hypertrophic Cardiomyopathy). Am J Cardiol. 2006; 98(7): 960-965. Go to original source... Go to PubMed...
    42. Le Tourneau T, Messika-Zeitoun D, Russo A, et al. Impact of left atrial volume on clinical outcome in organic mitral regurgitation. J Am Coll Cardiol. 2010; 56(7): 570-578. Go to original source... Go to PubMed...
    43. Barnes ME, Miyasaka Y, Seward JB, et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc 2004; 79: 1008-1014. Go to original source... Go to PubMed...
    44. Benjamin EJ, D'Agostino RB, Belanger AJ, et al. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation 1995; 92: 835-841. Go to original source... Go to PubMed...
    45. Psaty BM, Manolio TA, Kuller LH, et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation 1997; 96: 2455-2461. Go to original source... Go to PubMed...
    46. Wozakowska-Kaplon B, Opolski G. Concomitant recovery of atrial mechanical and endocrine function after cardioversion in patients with persistent atrial fibrillation. J Am Coll Cardiol 2003; 41(10): 1716-1720. Go to original source... Go to PubMed...
    47. Takahashi Y, O'Neill MD, Hocini M, et al. Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties. J Am Coll Cardiol 2007; 49(12): 1306-1314. Go to original source... Go to PubMed...
    48. Fiala M, Wichterle D, Bulková V, et al. Hemodynamics, functional status, and quality of life after radiofrequency catheter ablation of long-standing persistent atrial fibrillation. J Interv Cardiovasc Electrophysiol 2012; accepted for publication.
    49. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 1996; 61: 755-759. Go to original source... Go to PubMed...
    50. Kuppahally SS, Akoum N, Burgon NS, et al. Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation. Relationship to left atrial structural remodeling detected by delayed-enhancement MRI. Circ Cardiovasc Imaging 2010; 3: 231-239. Go to original source... Go to PubMed...
    51. Fiala M, Wichterle D, Chovančík J, et al. Left atrial voltage during atrial fibrillation in paroxysmal and persistent atrial fibrillation patients. Pacing Clin Electrophysiol 2010; 33: 541-548. Go to original source... Go to PubMed...
    52. Fatkin D, Feneley MP. Patterns of Doppler-measured blood flow velocity in the normal and fibrillating human left atrial appendage. Am Heart J 1996; 132: 995-1003. Go to original source... Go to PubMed...
    53. Jue J, Winslow T, Fazio G, et al. Pulsed Doppler characterization of left atrial appendage flow. J Am Soc Echocardiogr 1993; 6: 237-244. Go to original source... Go to PubMed...
    54. Tabata T, Oki T, Fukuda, et al. Influence of aging on left atrial appendage flow velocity patterns in normal subjects. J Am Soc Echocardiogr 1996; 9: 274-280. Go to original source... Go to PubMed...
    55. Agmon Y, Khandheira BK, Gentile F, et al. Echocardiographic assessment of the left atrial appendage. J A Coll Cardiol 1999; 34: 1867-1877. Go to original source... Go to PubMed...
    56. Yuda S, Nakatani S, Kosakai Y, et al. Long-term follow-up of atrial contraction after the maze procedure in patients with mitral valve disease. J Am Coll Cardiol 2001; 37: 1622-1627. Go to original source... Go to PubMed...
    57. Bauer EP, Szalay ZA, Brandt RR, et al. Predictors for atrial transport function after mini-maze operation. Ann Thorac Surg 2001; 72: 1251-1254. Go to original source... Go to PubMed...
    58. Isobe F, Kumano H, Ishikawa T, et al. A new procedure for chronic atrial fibrillation: bilateral appendage-preserving maze procedure. Ann Thorac Surg 2001; 72: 1473-1478. Go to original source... Go to PubMed...

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