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Usefulness of the pulmonary venous flow waveform for assessing left atrial stiffness

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Title: Usefulness of the pulmonary venous flow waveform for assessing left atrial stiffness
Authors: Abe, Takehiro Browse this author
Okada, Kazunori Browse this author
Murayama, Michito Browse this author →KAKEN DB
Kaga, Sanae Browse this author →KAKEN DB
Nakabachi, Masahiro Browse this author
Yokoyama, Shinobu Browse this author
Nishino, Hisao Browse this author
Aoyagi, Hiroyuki Browse this author
Tamaki, Yoji Browse this author
Motoi, Ko Browse this author
Chiba, Yasuyuki Browse this author
Ishizaka, Suguru Browse this author
Tsujinaga, Shingo Browse this author →KAKEN DB
Iwano, Hiroyuki Browse this author →KAKEN DB
Kamiya, Kiwamu Browse this author →KAKEN DB
Nagai, Toshiyuki Browse this author →KAKEN DB
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: Echocardiography
Pulmonary venous flow
Left atrial stiffness
Speckle tracking echocardiography
Left atrial v-wave
Issue Date: 16-Jul-2022
Journal Title: The International Journal of Cardiovascular Imaging
Volume: 39
Issue: 1
Start Page: 23
End Page: 34
Publisher DOI: 10.1007/s10554-022-02689-7
PMID: 36598682
Abstract: Purpose This study investigated the novel non-invasive left atrial (LA) stiffness parameter using pulmonary venous (PV) flow measurements and the clinical usefulness of the novel LA stiffness parameter. Methods We retrospectively analyzed 237 patients who underwent right heart catheterization and echocardiography less than one week apart. From the pulmonary artery wedge pressure waveform, the difference between x-descent and v-wave (Delta P) was measured. Using the echocardiographic biplane method of disks, the difference between LA maximum volume and that just before atrial contraction (Delta V-MOD) was calculated, and the Delta P/Delta V-MOD was calculated as a standard LA stiffness index. From the PV flow waveform, the peak systolic velocity (S), peak diastolic velocity (D), and minimum velocity between them (R) were measured, and S/D, S/R, and D/R were calculated. From the speckle tracking echocardiography-derived time-LA volume curve, the difference between LA maximum volume and that just before atrial contraction (Delta V-STE) was measured. Each patient's prognosis was investigated until three years after echocardiography. Results Among the PV flow parameters, D/R was significantly correlated with Delta P (r = 0.62), and the correlation coefficient exceeded that between S/D and Delta P (r = - 0.39) or S/R and Delta P (r = 0.14). The [D/R]/Delta V-STE was significantly correlated with Delta P/Delta V-MOD (r = 0.61). During the follow-up, 37 (17%) composite endpoints occurred. Kaplan-Meier analysis showed that patients with [D/R]/Delta V-STE greater than 0.13 /mL were at higher risk of cardiac events. Conclusion The [D/R]/Delta V-STE was useful for assessing LA stiffness non-invasively and might be valuable in the prognostic evaluation of patients with cardiac diseases.
Rights: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Type: article (author version)
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 岡田 一範

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