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A new method for the evaluation of atrial function: transthoracic tissue Doppler echocardiography

A new method for the evaluation of atrial function: transthoracic tissue Doppler echocardiography. T. Palecek, V. Dambrauskaite, E. Eroglu, S. Langeland, J. D´hooge, P. Claus, B. Bijnens, G. R. Sutherland. Atrial Function.

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A new method for the evaluation of atrial function: transthoracic tissue Doppler echocardiography

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  1. A new method for the evaluation of atrial function: transthoracic tissue Doppler echocardiography

  2. T. Palecek, V. Dambrauskaite, E. Eroglu, S. Langeland, J. D´hooge, P. Claus, B. Bijnens, G. R. Sutherland

  3. Atrial Function Hemodynamic function of the atria – 3 phases: • Booster pump Active atrial emptying, followed by atrial relaxation • Reservoir During ventricular systole, storing blood and energy • Conduit During rapid ventricular filling, passive emptying of the atria, followed by plateau (diastasis)

  4. Echocardiographic Evaluation of Atrial Function Various parameters derived from M-mode, 2D-grey scale and blood pool Doppler echocardiography proposed: Atrial diameters, areas, volumes  emptying fractions and volumes, ejection fraction, expansion index Transmitral and pulmonary vein flow variables  velocity ratios, atrial kinetic energy • However, the assessment of atrial function still remains a diagnostic challenge

  5. Tissue Doppler Echocardiography(TDE) • A recently developed ultrasonic technique allowing quantitative analysis of myocardial velocities • TDE evaluation of ventricular function has been largely documented • TDE by measuring atrial velocities could also quantify atrial function

  6. The Aim of the Study • Feasibility study • To define normal atrial radial velocity profiles and determine the potential clinical role of transthoracic TDE in assessing atrial function

  7. Methods • 10 young healthy subjects (31±4 years, 8 males) Sinus rhythm Normal standard echocardiographic examination • To determine normal radial velocity profiles, pulsed wave TDE recordings (sample volume 5-10mm) of left and right atrial superior wall motion were performed Left atrial superior wall motion recorded in apical 4-chamber (A4C) and 2-chamber (A2C) views Right atrial superior wall motion recorded in A4C and parasternal short axis (SAx) views

  8. Atrial Radial Velocities Passive forward motion during ventricular contraction Atrial contraction Left Atrium Right Atrium Atrial relaxation Passive backward motion during rapid ventricular filling

  9. Peak Atrial Radial Contraction (AC) and Relaxation (AR) Velocities Left Atrium Right Atrium AC Vel (m.s-1) AR Vel (m.s-1) AC Vel (m.s-1) AR Vel (m.s-1) A4C A4C 0,06±0,01** 0,04±0,01* 0,04±0,01 0,03±0,01 A2C 0,05±0,01* SAx 0,04±0,01 0,03±0,01 0,06±0,02** * p < 0,01 for the difference between left and right AR velocities **p < 0,001 for the difference between left and right AC velocities

  10. Correlation between Peak AC and AR Radial Velocities

  11. Conclusions • In normal subjects, AC and AR radial velocities from both atria could be consistently and reproducibly recorded. • Left AC and AR radial velocities were higher then their right atrial equivalents. • The values of AR velocities strongly correlated with the values of AC velocities. • Tissue Doppler indices represent a promising new method to investigate atrial function.

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