Vnitr Lek 2012, 58(2):118-122

Clinical implications of enlargement of left atrium

Ľ. Družbacká1,*, G. Valočik1, M. Jakubová2, B. Stančák1, L. Fojtíková1
1 Klinika kardiológie Lekárskej fakulty UPJŠ a VÚSCH a.s., Košice, Slovenská republika, prednosta doc. MUDr. Branislav Stančák, CSc.
2 Klinika anestéziológie a intenzívnej medicíny Lekárskej fakulty UPJŠ a VÚSCH a.s., Košice, Slovenská republika, prednosta doc. MUDr. Pavol Török, CSc.

Enlargement of left atrium (LA) has been shown to be a barometer of diastolic burden and a predictor of common cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, and cardiovascular death. Different methods exist for the assessment of LA size. The American Society of Echocardiography recommended LA volume and its indexed value assessed by 2-dimensional echocardiography, to measure LA size. Current findings suggest that echocardiographically determined LA size may become an important clinical risk identifier in preclinical cardiovascular disease and should be assessed as a part of routine echocardiographic evaluation.

Keywords: left atrium; left atrial volume; cardiovascular outcomes

Received: May 2, 2011; Accepted: July 28, 2011; Published: February 1, 2012  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Družbacká Ľ, Valočik G, Jakubová M, Stančák B, Fojtíková L. Clinical implications of enlargement of left atrium. Vnitr Lek. 2012;58(2):118-122.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol 2003; 42: 1206-1207. Go to original source... Go to PubMed...
    2. Appleton CP, Galloway JM, Gonzalez MS et al. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. J Am Coll Cardiol 1993; 22: 1972-1982. Go to original source... Go to PubMed...
    3. Osranek M, Seward JB, Buschenreithner B et al. Diastolic function assessment in clinical practice: the value of 2-dimensional echocardiography. Am Heart J 2007; 154: 130-136. Go to original source... Go to PubMed...
    4. 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: 1284-1289. Go to original source... Go to PubMed...
    5. Thomas L. Assessment of atrial function. Heart Lung Circ 2007; 16: 234-242. Go to original source... Go to PubMed...
    6. Tsang TS, Abhayaratna WP, Barnes ME et al. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol 2006; 47: 1018-1023. Go to original source... Go to PubMed...
    7. 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...
    8. Gonçalvesová E. Prínos natriuretických peptidov pre diagnózu, prognózu, manažment a liečbu srdcového zlyhávania. Interní Med 2006; 10: 428-431.
    9. Lang RM, Bierig M, Devereux RB et al. Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography. 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...
    10. Abhayaratna WP, Seward JB, Appleton CP et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol 2006; 47: 2357-2363. Go to original source... Go to PubMed...
    11. Pagel PS, Kehl F, Gare M et al. Mechanical function of the left atrium: New insights based on analysis of pressure-volume relations and Doppler echocardiography. Anesthesiology 2003; 98: 975-994. Go to original source... Go to PubMed...
    12. Matsuda Y, Toma Y, Ogawa H et al. Importance of left atrial function in patients with myocardial infarction. Circulation 1983; 67: 566-571. Go to original source... Go to PubMed...
    13. Thomas L, Levett K, Boyd A et al. Compensatory changes in atrial volumes with normal aging: is atrial enlargement inevitable? J Am Coll Cardiol 2002; 40: 1630-1635. Go to original source... Go to PubMed...
    14. Braunwald E, Frahm CJ, Ross J Jr. Studies on Starling's law of the heart. IV. observations on the hemodynamic functions of the left atrium in man. Circulation 1961; 24: 633-642. Go to original source...
    15. Thomas L, Levett K, Boyd A et al. Changes in regional left atrial function with aging evaluation by Doppler tissue imaging. Eur J Echocardiogr 2003; 4: 92-100. Go to original source...
    16. Nikitin NP, Witte KK, Thackray SD et al. Effect of age and sex on left atrial morphology and function. Eur J Echocardiogr 2003; 4: 36-42. Go to original source...
    17. Vaziri SM, Larson MG, Benjamin EJ et al. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study. Circulation 1994; 89: 724-730. Go to original source... Go to PubMed...
    18. Gottdiener JS, Reda JD, Williams DW et al. Left Atrial Size in Hypertensive Men: Influence of Obesity, Race and Age. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. J Am Coll Cardiol 1997; 29: 651-658. Go to original source... Go to PubMed...
    19. Strizke J, Markus MR, Duderstadt S et al. MONICA/KORA Investigators. The aging process of the heart: Obesity is the main risk factor for left atrial enlargement during aging the MONICA/KORA (monitoring of trends and determinations in cardiovascular disease/cooperative research in the region of Augsburg) study. J Am Coll Cardiol 2009; 54: 1982-1989. Go to original source... Go to PubMed...
    20. Triposkiadis F, Tentolouris K, Androulakis A et al. Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr 1995; 8: 801-809. Go to original source... Go to PubMed...
    21. Pearlman JD, Triulzi MO, King ME et al. Left atrial dimensions in growth and development: normal limits for two-dimensional echocardiography. J Am Coll Cardiol 1990; 16: 1168-1174. Go to original source... Go to PubMed...
    22. Amar D, Zhang H, Leung DH et al. Older age is the strongest predictor of postoperative atrial fibrillation. Anesthesiology 2002; 96: 352-356. Go to original source... Go to PubMed...
    23. Jakubová M, Družbacká Ľ, Stančák B et al. Prečo vzniká fibrilácia predsiení po kardiochirurgických operáciách? Vnitř Lék 2011; 57: 92-96. Go to PubMed...
    24. Allesie MA, Boyden PA, Camm AJ et al. Patophysiology and prevention of atrial fibrillation. Circulation 2001; 103: 769-777. Go to original source... Go to PubMed...
    25. Downes TR, Nomeir AM, Smith KM et al. Mechanism of altered pattern of left ventricular filling with aging in subjects without cardiac disease. Am J Cardiol 1989; 64: 523-527. Go to original source... Go to PubMed...
    26. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part II: the aging heart in health: links to heart disease. Circulation 2003; 107: 346-354. Go to original source... Go to PubMed...
    27. Stefanadis C, Dernellis J, Stratos C et al. Assessment of left atrial pressure-area relation in humans by means of retrograde left atrial catheterization and echocardiographic automatic boundary detection: Effect of dobutamine. J Am Coll Cardiol 1998; 31: 426-436. Go to original source... Go to PubMed...
    28. Leistad E, Christensen G, Ilebekk A. Significance of increased atrial pressure on stroke volume during atrial fibrillation in anaesthetized pigs. Acta Physiol Scand 1993; 149: 157-161. Go to original source... Go to PubMed...
    29. Tokushima T, Utsunomiya T, Yoshida K et al. Left Atrial Systolic Function Assessed by Left Atrial Ejection Force in Patients with Sick Sinus Syndrome and Paroxysmal Atrial Fibrillation. Jpn Heart J 2000; 41: 723-732. Go to original source... Go to PubMed...
    30. Zipes DP. Atrial fibrillation: A tachycardia-induced atrial cardiomyopathy. Circulation 1997; 95: 562-564. Go to original source... Go to PubMed...
    31. Morillo CA, Klein GJ, Jones DL et al. Chronic rapid atrial pacing: Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation. Circulation 1995; 91: 1588-1595. Go to original source... Go to PubMed...
    32. Fatkin D, Kuchar DL, Thorburn CW et al. Transesophageal echocardiography before and during direct current cardioversion of atrial fibrillation: Evidence for atrial stunning as a mechanism of thromboembolic complications. J Am Coll Cardiol 1994; 23: 307-316. Go to original source... Go to PubMed...
    33. Mattioli AV, Sansoni S, Lucchi GR et al. Serial evaluation of left atrial dimension after cardioversion for atrial fibrillation and relation to atrial function. Am J Cardiol 2000; 85: 832-836. Go to original source... Go to PubMed...
    34. Louie EK, Liu D, Reynertson SI et al. Stunning of the left atrium after spontaneous conversion of atrial fibrillation to sinus rhythm: Demonstration by transesophageal Doppler techniques in a canine model. J Am Coll Cardiol 1998; 32: 2081-2086. Go to original source... Go to PubMed...
    35. Ito Y, Arakawa M, Noda T et al. Atrial reservoir and active transport function after cardioversion of chronic atrial fibrillation. Heart Vessels 1996; 11: 30-38. Go to original source... Go to PubMed...
    36. 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...
    37. Tani T, Tanabe K, Ono M et al. Left atrial volume and the risk of paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. Am Soc Echocardiogr 2004; 17: 644-648. Go to original source... Go to PubMed...
    38. Tsang TS, Barnes ME, Bailey KR et al. Left atrial volume important risk marker of incident atrial fibrillation in 1,655 older men and women. Mayo Clin Proc 2001; 76: 467-475. Go to original source... Go to PubMed...
    39. Fatema K, Barnes ME, Bailey KR et al. Minimum vs. maximum left atrial volume for prediction of first atrial fibrillation or flutter in an elderly cohort: a prospective study. Eur J Echocardiogr 2009; 10: 282-286. Go to original source... Go to PubMed...
    40. American Heart Association Heart Disease and Stroke Statistics - 2005 Update. Dallas, TX: American Heart Association; 2003.
    41. 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...
    42. Di Tullio MR, Sacco RL, Sciacca RR et al. Left atrial size and the risk of ischemic stroke in an ethnically mixed population. Stroke 1999; 30: 2019-2024. Go to original source... Go to PubMed...
    43. Gottdiener JS, Kitzman DW, Aurigemma GP et al. Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons ≥ 65 years of age (the Cardiovascular Health Study). Am J Cardiol 2006; 97: 83-89. Go to original source... Go to PubMed...
    44. Takemoto Y, Barnes ME, Seward JB et al. Usefulness of left atrial volume in predicting first congestive heart failure in patients ≥ 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...
    45. Bhatia RS, Tu JV, Lee DS et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 2006; 355: 260-269. Go to original source... Go to PubMed...
    46. Nishimura RA, Housmans PR, Hatle LK et al. Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part I. Physiologic and pathophysiologic features. Mayo Clin Proc 1989; 64: 71-81. Go to original source... Go to PubMed...
    47. Leung DY, Boyd AB, Ng AA et al. Echocardiographic evaluation of left atrial size and function: Current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J 2008; 156: 1056-1064. Go to original source... Go to PubMed...
    48. Paulus WJ, Tschöpe C, Sanderson JE et al. 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. Eur Heart J 2007; 28: 2539-2550. Go to original source... Go to PubMed...
    49. Gardin JM, McClelland R, Kitzman D et al. M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study). Am J Cardiol 2001; 87: 1051-1057. Go to original source... Go to PubMed...
    50. Pritchett AM, Jacobsen SJ, Mahoney DW et al. Left atrial volume as an index of left atrial size: a population-based study. J Am Coll Cardiol 2003; 41: 1036-1043. Go to original source... Go to PubMed...
    51. Tsang TS, Barnes ME, Gersh BJ et al. Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography. J Am Coll Cardiol 2003; 42: 1199-1205. Go to original source... Go to PubMed...
    52. 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: 1425-1430. Go to original source... Go to PubMed...
    53. Giannuzzi P, Temporelli PL, Bosimini E et al. Independent and incremental prognostic value of Doppler-derived mitral deceleration time of early filling in both symptomatic and asymptomatic patients with left ventricular dysfunction. J Am Coll Cardiol 1996; 28: 383-390. Go to original source... Go to PubMed...
    54. Cabin HS, Clubb KS, Hall C et al. Risk for systemic embolization of atrial fibrillation without mitral stenosis. Am J Cardiol 1990; 65: 1112-1116. Go to original source... Go to PubMed...
    55. 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: 327-334. Go to original source... Go to PubMed...
    56. Rossi A, Tomaino M, Golia G et al. Usefulness of left atrial size in predicting postoperative symptomatic improvement in patients with aortic stenosis. Am J Cardiol 2000; 86: 567-570. Go to original source... Go to PubMed...
    57. Reed D, Abbott RD, Smucker ML et al. Prediction of outcome after mitral valve replacement in patients with symptomatic chronic mitral regurgitation. The importance of left atrial size. Circulation 1991; 84: 23-34. Go to original source... Go to PubMed...
    58. Gerdts E, Wachtell K, Omvik P et al. Left atrial size and risk of major cardiovascular events during antihypertensive treatment: losartan intervention for endpoint reduction in hypertension trial. Hypertension 2007; 49: 311-316. Go to original source... Go to PubMed...
    59. 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...
    60. Patel DA, Lavie CJ, Milani RV et al. Left atrial volume index and left ventricular geometry independently predict mortality in 47,865 patients with preserved ejection fraction. Circulation 2008; 118: S843. Go to original source...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.