Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function

Paolo Barbier, Steven B. Solomon, Nelson B. Schiller, Stanton A. Glantz

Research output: Contribution to journalArticle

Abstract

Background - Determinants of left atrial (LA) reservoir function and its influence on left ventricular (LV) function have not been quantified. Methods and Results - In an open-pericardium, paced (70 and 90 bpm) pig model of LV regional ischemia (left anterior descending coronary constriction), with high-fidelity LV, LA, and RV pressure recordings, we obtained the LA area with 2D automated border detection echocardiography, LA pressure-area loops, and Doppler transmitral flow. We calculated LV τ, LA relaxation (a - x pressure difference divided by time, normalized by a pressure), and stiffness (slope between x and v pressure points of v loop). Determinants of total LA reservoir (maximum-minimum area, cm2) were identified by multiple regression analysis. Different mean rates of LA area increase identified 2 consecutive (early rapid and late slow) reservoir phases. During ischemia, LV long-axis shortening (LAS, LV base systolic descent) and LA reservoir area change decreased (7.3±0.3 [SEMI versus 5.6+0.3 cm2, P2, P=0.009). Early reservoir area change depended on LA mean ejection rate (LA area at ECG P wave minus minimum area divided by time; multiple regression coefficient=0.9; P2 x ms/s; P4/mm Hg; P=0.001) and cardiac output (coefficient=0.001 cm2 x min/L; P=0.002). The strongest predictor of cardiac output was LA reservoir filling (coefficient=301 L/min x cm2; P

Original languageEnglish
Pages (from-to)427-436
Number of pages10
JournalCirculation
Volume100
Issue number4
Publication statusPublished - Jul 27 1999

Keywords

  • Atrium
  • Hemodynamics
  • Mechanics

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Barbier, P., Solomon, S. B., Schiller, N. B., & Glantz, S. A. (1999). Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation, 100(4), 427-436.