Objective: Left atrial (LA) maximum volume (LAV max) is an indicator of left ventricular (LV) diastolic function. However, LAV max is also influenced by systolic events, whereas the LA minimum volume (LAV min) is directly exposed to LV pressure. The authors hypothesised that LAV min may be a better correlate of LV diastolic function than LAV max. Design: Cross-sectional. Setting: University hospital. Patients: 357 participants from a community-based cohort study. Methods: LA volumes and reservoir function, measured as total LA emptying volume (LAEV) and LA emptying fraction (LAEF), were assessed by real-time three-dimensional echocardiography. LV diastolic function was assessed by trans-mitral early (E) and late (A) Doppler velocities and mitral early diastolic velocity by tissue-Doppler (e′). LV systolic function was assessed by LV ejection fraction (LVEF) and global longitudinal strain (GLS) by speckle-tracking. Results: LAV min significantly increased with worsening diastolic dysfunction (p<0.001), whereas the increase in LAV max was less pronounced (p=0.07). LAEV and LAEF decreased with worsening diastolic dysfunction (both p<0.001). In linear regressions, LAV min and LAV max were significant predictors of E/e′, with higher parameter estimates for LAV min. In multivariate models, LAV minresulted strongly associated with E/e′ (β=0.45, p<0.001), whereas LAV max was not (β=-0.16, p=0.08). LA reservoir function was better associated with GLS than LVEF. In multivariate analyses, GLS was significantly associated with LAV max (β=-0.15, p=0.002), LAEV (β=-0.37, p<0.001) and LAEF (β=-0.28, p<0.001) but not with LAV min. Conclusions: LAV min is a better correlate of LV diastolic function than LAV max. The impact of LV longitudinal systolic function on LA reservoir function might explain the weaker relation between LAV max and LV diastolic function.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine