Left atrial volume in children without heart disease and in those with ventricular septal defect or patent ductus arteriosus or hypertrophic cardiomyopathy.
Summary of "Left atrial volume in children without heart disease and in those with ventricular septal defect or patent ductus arteriosus or hypertrophic cardiomyopathy."
In adults, the left atrial (LA) volume has been shown to reflect diastolic function and is a powerful predictor of cardiac morbidity and mortality. Normative LA volume values in children and the effect of loading conditions on the LA volume in those with congenital heart disease are lacking. The purposes of the present study were to (1) establish normal LA volume values for children, (2) assess the effect of left ventricular volume loading conditions on LA volume, and (3) describe the effect of abnormal myocardial relaxation on the LA volume. We retrospectively reviewed the echocardiograms from 3 pediatric cohorts: group N (n = 522), children with normal echocardiographic findings; group VSD/PDA (n = 71), children with ventricular septal defect (VSD; n = 50) or patent ductus arteriosus (PDA; n = 21); and group HC (n = 63), children with hypertrophic cardiomyopathy (HC). In group N, we identified the LA volume indexed to the body surface area (LA volume index) as a consistent measure of the LA volume in children 3 to 23 months old (mean 16 ± 3 ml/m(2)) and 2 to 17 years old (mean 22 ± 4 ml/m(2)). LA dilation was more common in group VSD/PDA than in group N (27% vs 2%, p <0.0001) and in children with moderate or large shunts than in those with smaller shunts (61% vs 5%, p <0.0001). In group HC, the LA volume index correlated with the mitral valve E/e' ratio (p <0.0001). In conclusion, this is the first study to establish normal pediatric LA volume values. The LA volume index is a reproducible measure of LA size in children ≥3 months old. The LA volume index reflects a chronically increased left ventricular volume load in children with VSD or PDA and chronically elevated left ventricular filling pressures in children with HC.
Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
This article was published in the following journal.
Name: The American journal of cardiology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21059443
- DOI: http://dx.doi.org/10.1016/j.amjcard.2010.07.015
Medical and Biotech [MESH] Definitions
Ventricular Function, Left
The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.
The thin membrane-like muscular structure separating the right and the left upper chambers (HEART ATRIA) of a heart.
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).
Rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES).
Absence of the orifice between the RIGHT ATRIUM and RIGHT VENTRICLE, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR) because the right ventricle is absent or not functional.
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