Navegando por Palavras-chave "Left atrium"

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    Left Atrial Dysfunction in Chagas Cardiomyopathy Is More Severe Than in Idiopathic Dilated Cardiomyopathy: A Study with Real-Time Three-Dimensional Echocardiography
    (Elsevier B.V., 2011-05-01) Mancuso, Frederico José Neves [UNIFESP]; Almeida, Dirceu Rodrigues de [UNIFESP]; Moisés, Valdir Ambrósio [UNIFESP]; Oliveira, Wercules Antonio [UNIFESP]; Mello, Eduardo S. [UNIFESP]; Poyares, Dalva [UNIFESP]; Tufik, Sergio [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Campos, Orlando [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Although there is anatomopathologic evidence of atrial involvement in Chagas cardiomyopathy (CCM), the impact in left atrial (LA) function is unknown. the aim of this study was to evaluate LA function in patients with CCM with real-time three-dimensional echocardiography (RT3DE) and to compare it with patients with idiopathic dilated cardiomyopathy (DCM).Methods: A total of 30 patients with CCM, 30 patients with DCM, and 20 normal subjects used as the control group were studied. With the use of RT3DE, we measured LA maximum (maxLAV), minimum, and pre-atrial contraction volumes and calculated total and active LA emptying fractions.Results: Left ventricular ejection fraction and mitral regurgitation were similar in both groups. MaxLAV/m(2) was larger in the CCM group than in the DCM group (76.9 +/- 21.9 mL vs. 59.1 +/- 26.0 mL; P < .01), and both were significantly larger than in the control group (P < .01). Total LA emptying fraction was lower in the CCM group than in the DCM group (0.30 +/- 0.10 vs. 0.40 +/- 0.12; P < .01), and both were lower than in the control group (P = .01). Active LA emptying fraction was also lower in the CCM group than in the DCM group (0.22 +/- 0.09 vs. 0.28 +/- 0.11; P < .01), and both were lower than in the control group (P = .01). the E/e' ratio was higher in the CCM group than in the DCM group (21 +/- 10 vs. 15 +/- 6; P < .01), and both were greater than in the control group (P < .01). in a multiple regression model, the E/e' ratio was the only independent predictor of a worsening active LA emptying fraction.Conclusion: LA function is more compromised in patients with CCM than in patients with DCM. This finding indicates a more diffuse and severe myocardial impairment in Chagas disease that is probably related to increased left ventricular filling pressures and atrial myopathy. (J Am Soc Echocardiogr 2011;24:526-32.)
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    Left Atrial Volume and Function in Patients With Obstructive Sleep Apnea Assessed by Real-Time Three-Dimensional Echocardiography
    (Elsevier B.V., 2008-12-01) Oliveira, Wercules [UNIFESP]; Campos, Orlando [UNIFESP]; Lira-Filho, Edgar Bezerra [UNIFESP]; Cintra, Fatima Dumas [UNIFESP]; Vieira, Marcelo; Ponchirolli, Andrea [UNIFESP]; De Paola, Angelo de [UNIFESP]; Tufik, Sergio [UNIFESP]; Poyares, Dalva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Albert Einstein Hosp
    Background: Studies have suggested that obstructive sleep apnea (OSA) contributes to the deterioration of left ventricular diastolic function. This may lead to atrial myocardial overstretching and enlargement, which could be associated with increased cardiovascular risk. the aim of this study was to evaluate left atrial (LA) volume and function in patients with OSA compared with controls without OSA and their associations with any left ventricular diastolic abnormalities using real-time 3-dimensional echocardiography (RT3DE).Methods: Fifty-six patients with mild to severe OSA and 50 controls of similar age and with similar body mass indexes, blood pressure, and frequency of hypertension were analyzed. All subjects underwent polysomnography and RT3DE.Results: A larger 3-dimensional maximum LA volume indexed for body surface area, larger volume before atrial contraction, and higher active atrial ejection fraction were found in patients with OSA (P < .01 for all). Mitral annular early diastolic velocity (E') was reduced in patients with OSA (P = .03), whereas late diastolic velocity (A') and the ratio of mitral valve early diastolic velocity to mitral annular early diastolic velocity (E/E') were increased in the same group (P < .05 for both). in addition, a lower E'/A' ratio was also found in the OSA group (P = .02). An increase in 3-dimensional maximum LA volume indexed for body surface area was observed, depending on OSA severity. the apnea-hypopnea index and E/E' ratio were independent predictors of an increase in 3-dimensional maximum LA volume in a multiple regression model.Conclusion: Using RT3DE, this study demonstrates that OSA induces a functional burden on the left atrium, resulting in remodeling. These functional and structural changes are related to the impairment of diastolic function in this population. (J Am Soc Echocardiogr 2008; 21: 1355-1361.)