Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1993 Jan;69(1):31–35. doi: 10.1136/hrt.69.1.31

Increased left atrial chamber stiffness in hypertrophic cardiomyopathy.

H Sanada 1, M Shimizu 1, N Sugihara 1, K Shimizu 1, H Ino 1, R Takeda 1
PMCID: PMC1024912  PMID: 8457391

Abstract

OBJECTIVE--To investigate left atrial chamber stiffness and its influence on left atrial and left ventricular functions in hypertrophic cardiomyopathy. DESIGN--Prospective study. SETTING--Department of internal medicine in a university teaching hospital. PATIENTS--Five control subjects, six patients with essential hypertension, and 11 patients with hypertrophic cardiomyopathy. INTERVENTIONS--Measurement of left atrial pressure by a tip micromanometer and of real-time left atrial volume from left atrial cineangiograms. MAIN OUTCOME MEASURE--Left atrial stiffness constant determined by fitting the ascending limb of the v loop of the left atrial pressure-volume relation to an exponential curve. RESULTS--The mean (SD) left atrial chamber stiffness constant was significantly larger in patients with hypertrophic cardiomyopathy than in controls (0.063 (0.018) v 0.041 (0.006), p < 0.05) and was correlated with left ventricular wall thickness (r = 0.560, p < 0.01). Left atrial reservoir volume (left atrial emptying volume before atrial contraction) was significantly smaller in patients with hypertrophic cardiomyopathy than in the controls (7.3 (2.1) v 12.5 (4.4) ml/m2, p < 0.01) and was inversely correlated with the left atrial chamber stiffness constant (r = -0.598, p < 0.01). The cardiac index was inversely correlated with the left atrial chamber stiffness constant (r = -0.542, p < 0.01). CONCLUSIONS--Left atrial chamber stiffness was increased in patients with hypertrophic cardiomyopathy and this affected the left atrial reservoir function. This may in turn have affected cardiac output.

Full text

PDF
31

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BURCHELL H. B. A CLINICAL APPRAISAL OF ATRIAL TRANSPORT FUNCTION. Lancet. 1964 Apr 11;1(7337):775–779. doi: 10.1016/s0140-6736(64)92976-9. [DOI] [PubMed] [Google Scholar]
  2. Barry W. H., Brooker J. Z., Alderman E. L., Harrison D. C. Changes in diastolic stiffness and tone of the left ventricle during angina pectoris. Circulation. 1974 Feb;49(2):255–263. doi: 10.1161/01.cir.49.2.255. [DOI] [PubMed] [Google Scholar]
  3. Gaasch W. H., Battle W. E., Oboler A. A., Banas J. S., Jr, Levine H. J. Left ventricular stress and compliance in man. With special reference to normalized ventricular function curves. Circulation. 1972 Apr;45(4):746–762. doi: 10.1161/01.cir.45.4.746. [DOI] [PubMed] [Google Scholar]
  4. Gaasch W. H., Levine H. J., Quinones M. A., Alexander J. K. Left ventricular compliance: mechanisms and clinical implications. Am J Cardiol. 1976 Nov 4;38(5):645–653. doi: 10.1016/s0002-9149(76)80015-x. [DOI] [PubMed] [Google Scholar]
  5. Glancy D. L., O'Brien K. P., Gold H. K., Epstein S. E. Atrial fibrillation in patients with idiopathic hypertrophic subaortic stenosis. Br Heart J. 1970 Sep;32(5):652–659. doi: 10.1136/hrt.32.5.652. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Grossman W., McLaurin L. P., Moos S. P., Stefadouros M., Young D. T. Wall thickness and diastolic properties of the left ventricle. Circulation. 1974 Jan;49(1):129–135. doi: 10.1161/01.cir.49.1.129. [DOI] [PubMed] [Google Scholar]
  7. Mercadier J. J., de la Bastie D., Ménasché P., N'Guyen Van Cao A., Bouveret P., Lorente P., Piwnica A., Slama R., Schwartz K. Alpha-myosin heavy chain isoform and atrial size in patients with various types of mitral valve dysfunction: a quantitative study. J Am Coll Cardiol. 1987 May;9(5):1024–1030. doi: 10.1016/s0735-1097(87)80303-0. [DOI] [PubMed] [Google Scholar]
  8. Redwood D. R., Scherer J. L., Epstein S. E. Biventricular cineangiography in the evaluation of patients with asymmetric septal hypertrophy. Circulation. 1974 Jun;49(6):1116–1121. doi: 10.1161/01.cir.49.6.1116. [DOI] [PubMed] [Google Scholar]
  9. Ricksten S. E., Yao T., Ljung B., Thorén P. Distensibility of left atrium in normotensive and spontaneously hypertensive rats. Acta Physiol Scand. 1980 Dec;110(4):413–418. doi: 10.1111/j.1748-1716.1980.tb06688.x. [DOI] [PubMed] [Google Scholar]
  10. Wagner J. A., Sax F. L., Weisman H. F., Porterfield J., McIntosh C., Weisfeldt M. L., Snyder S. H., Epstein S. E. Calcium-antagonist receptors in the atrial tissue of patients with hypertrophic cardiomyopathy. N Engl J Med. 1989 Mar 23;320(12):755–761. doi: 10.1056/NEJM198903233201202. [DOI] [PubMed] [Google Scholar]
  11. Weiss J. L., Frederiksen J. W., Weisfeldt M. L. Hemodynamic determinants of the time-course of fall in canine left ventricular pressure. J Clin Invest. 1976 Sep;58(3):751–760. doi: 10.1172/JCI108522. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES