Abstract
Left atrial dimensions were measured using cross sectional echocardiography in 37 patients with mitral valve disease and 30 normal subjects of similar ages. The anteroposterior (AP), superior-inferior (SI), and medial-lateral (ML) left atrial dimensions were determined at the end of ventricular systole using parasternal long and short axis and apical four chamber views (for SIa and MLa). To assess the reliability of these measurements cross sectional echocardiographic and angiographic left atrial volumes were compared in 19 patients with mitral valve disease, giving an excellent correlation. A moderate correlation was found between the anteroposterior dimension of the left atrium obtained using M mode echocardiography and that obtained using the parasternal short axis and long axis projections. In normal subjects a good correlation was found between SI and ML dimensions, while a lower correlation was found between SI and AP, and ML and AP dimensions. The SI dimension was the major axis of the left atrium and AP dimension the minor axis. In patients with mitral valve disease a good correlation was found between SI and ML dimensions, while SI and ML dimensions had a low correlation with AP dimensions. The AP dimension was the minor axis of the left atrium, while the SI and ML dimensions were not significantly different. All left atrial dimensions were significantly greater in patients with mitral valve disease than in normal subjects. Of 30 patients with at least one dimension increased, all three dimensions were abnormal in 16, two dimensions were increased in 10, and only one dimension was increased in four. AP, SI, and ML dimensions were abnormal in 25, 20, and 27 patients, respectively. Cross sectional echocardiography may provide a reliable estimate of left atrial dimensions. In patients with mitral valve disease a thorough examination of the left atrium using multiple cross sectional views is necessary to detect asymmetric left atrial enlargement and to measure the degree of left atrial dilatation.
Full text
PDF








Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen H. D., Goldberg S. J., Sahn D. J., Ovitt T. W., Goldberg B. B. Suprasternal notch echocardiography. Assessment of its clinical utility in pediatric cardiology. Circulation. 1977 Apr;55(4):605–612. doi: 10.1161/01.cir.55.4.605. [DOI] [PubMed] [Google Scholar]
- Arcilla R. A., Thilenius O. G., Chiemmongkoltip P., Ranniger K. Left atrial volume calculation by angiocardiography in children. Chest. 1973 Feb;63(2):189–197. doi: 10.1378/chest.63.2.189. [DOI] [PubMed] [Google Scholar]
- Bommer W., Weinert L., Neumann A., Neef J., Mason D. T., DeMaria A. Determination of right atrial and right ventricular size by two-dimensional echocardiography. Circulation. 1979 Jul;60(1):91–100. doi: 10.1161/01.cir.60.1.91. [DOI] [PubMed] [Google Scholar]
- Brown O. R., Harrison D. C., Popp R. L. An improved method for echographic detection of left atrial enlargement. Circulation. 1974 Jul;50(1):58–64. doi: 10.1161/01.cir.50.1.58. [DOI] [PubMed] [Google Scholar]
- Bruns H. A., Brode P. Left atrial function studied by cineangiocardiographic volume determinations. I. Studies with casts of normal human atria. Am J Roentgenol Radium Ther Nucl Med. 1970 Nov;110(3):462–466. doi: 10.2214/ajr.110.3.462. [DOI] [PubMed] [Google Scholar]
- Bruns H. A. Left atrial function studied by cineangiocardiographic volume determinations. II. Clinical application. Am J Roentgenol Radium Ther Nucl Med. 1970 Nov;110(3):467–473. doi: 10.2214/ajr.110.3.467. [DOI] [PubMed] [Google Scholar]
- Burgess J., Clark R., Kamigaki M., Cohn K. Echocardiographic findings in different types of mitral regurgitation. Circulation. 1973 Jul;48(1):97–106. doi: 10.1161/01.cir.48.1.97. [DOI] [PubMed] [Google Scholar]
- DeMaria A. N., Bommer W., Joye J. A., Mason D. T. Cross-sectional echocardiography: physical principles, anatomic planes, limitations and pitfalls. Am J Cardiol. 1980 Dec 18;46(7):1097–1108. doi: 10.1016/0002-9149(80)90279-9. [DOI] [PubMed] [Google Scholar]
- Gehl L. G., Mintz G. S., Kotler M. N., Segal B. L. Left atrial volume overload in mitral regurgitation: a two dimensional echocardiographic study. Am J Cardiol. 1982 Jan;49(1):33–38. doi: 10.1016/0002-9149(82)90274-0. [DOI] [PubMed] [Google Scholar]
- Geiser E. A., Skorton D. J., Conetta D. A. Quantification of left ventricular function by two-dimensional echocardiography: consideration of factors restricting image quality. Am Heart J. 1982 May;103(5):905–910. doi: 10.1016/0002-8703(82)90406-9. [DOI] [PubMed] [Google Scholar]
- Goerke R. J., Carlsson E. Calculation of right and left cardiac ventricular volumes. Method using standard computer equipment and biplane angiocardiograms. Invest Radiol. 1967 Sep-Oct;2(5):360–367. doi: 10.1097/00004424-196709000-00017. [DOI] [PubMed] [Google Scholar]
- Gradin-Frimmer G., Lassvik C., Nylander E., Wranne B. Echocardiographic estimation of left atrial size from the apical view. Eur Heart J. 1982 Apr;3(2):159–163. doi: 10.1093/oxfordjournals.eurheartj.a061279. [DOI] [PubMed] [Google Scholar]
- Hawley R. R., Dodge H. T., Graham T. P. Left atrial volume and its changes in heart disease. Circulation. 1966 Dec;34(6):989–996. doi: 10.1161/01.cir.34.6.989. [DOI] [PubMed] [Google Scholar]
- Helak J. W., Plappert T., Muhammad A., Reichek N. Two dimensional echographic imaging of the left ventricle: comparison of mechanical and phased array systems in vitro. Am J Cardiol. 1981 Oct;48(4):728–735. doi: 10.1016/0002-9149(81)90152-1. [DOI] [PubMed] [Google Scholar]
- Henry W. L., DeMaria A., Gramiak R., King D. L., Kisslo J. A., Popp R. L., Sahn D. J., Schiller N. B., Tajik A., Teichholz L. E. Report of the American Society of Echocardiography Committee on Nomenclature and Standards in Two-dimensional Echocardiography. Circulation. 1980 Aug;62(2):212–217. doi: 10.1161/01.cir.62.2.212. [DOI] [PubMed] [Google Scholar]
- Hirata T., Wolfe S. B., Popp R. L., Helmen C. H., Feigenbaum H. Estimation of left atrial size using ultrasound. Am Heart J. 1969 Jul;78(1):43–52. doi: 10.1016/0002-8703(69)90257-9. [DOI] [PubMed] [Google Scholar]
- Kennedy J. W., Yarnall S. R., Murray J. A., Figley M. M. Quantitative angiocardiography. IV. Relationships of left atrial and ventricular pressure and volume in mitral valve disease. Circulation. 1970 May;41(5):817–824. doi: 10.1161/01.cir.41.5.817. [DOI] [PubMed] [Google Scholar]
- Kronzon I., Mehta S. S. Giant left atrium. Chest. 1974 Jun;65(6):677–679. doi: 10.1378/chest.65.6.677. [DOI] [PubMed] [Google Scholar]
- Kushner F. G., Lam W., Morganroth J. Apex sector echocardiography in evaluation of the right atrium in patients with mitral stenosis and atrial septal defect. Am J Cardiol. 1978 Nov;42(5):733–737. doi: 10.1016/0002-9149(78)90091-7. [DOI] [PubMed] [Google Scholar]
- Latson L. A., Cheatham J. P., Gutgesell H. P. Resolution and accuracy in two dimensional echocardiography. Am J Cardiol. 1981 Jul;48(1):106–110. doi: 10.1016/0002-9149(81)90578-6. [DOI] [PubMed] [Google Scholar]
- Lemire F., Tajik A. J., Hagler D. J. Asymmetric left atrial enlargement; an echocardiographic observation. Chest. 1976 Jun;69(6):779–781. doi: 10.1378/chest.69.6.779. [DOI] [PubMed] [Google Scholar]
- Levin A. R., Frand M., Baltaxe H. A. Left atrial enlargement. Correlation of left atrial volume with cardiac series, ciné-esophagography, and electrocardiography. Radiology. 1972 Sep;104(3):615–621. doi: 10.1148/104.3.615. [DOI] [PubMed] [Google Scholar]
- Lundström N. R., Mortensson W. Clinical applications of echocardiography in infants and children. II. Estimation of aortic root diameter and left atrial size: a comparison between echocardiography and angiocardiography. Acta Paediatr Scand. 1974 Jan;63(1):33–41. doi: 10.1111/j.1651-2227.1974.tb04346.x. [DOI] [PubMed] [Google Scholar]
- Murray J. A., Kennedy J. W., Figley M. M. Quantitative angiocardiography. II. The normal left atrial volume in man. Circulation. 1968 May;37(5):800–804. doi: 10.1161/01.cir.37.5.800. [DOI] [PubMed] [Google Scholar]
- SAUTER H. J., DODGE H. T., JOHNSTON R. R., GRAHAM T. P. THE RELATIONSHIP OF LEFT ATRIAL PRESSURE AND VOLUME IN PATIENTS WITH HEART DISEASE. Am Heart J. 1964 May;67:635–642. doi: 10.1016/0002-8703(64)90334-5. [DOI] [PubMed] [Google Scholar]
- SELLERS R. D., LEVY M. J., AMPLATZ K., LILLEHEI C. W. LEFT RETROGRADE CARDIOANGIOGRAPHY IN ACQUIRED CARDIAC DISEASE: TECHNIC, INDICATIONS AND INTERPRETATIONS IN 700 CASES. Am J Cardiol. 1964 Oct;14:437–447. doi: 10.1016/0002-9149(64)90027-x. [DOI] [PubMed] [Google Scholar]
- Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
- Schabelman S., Schiller N. B., Silverman N. H., Ports T. A. Left atrial volume estimation by two-dimensional echocardiography. Cathet Cardiovasc Diagn. 1981;7(2):165–178. doi: 10.1002/ccd.1810070206. [DOI] [PubMed] [Google Scholar]
- Schiller N. B., Acquatella H., Ports T. A., Drew D., Goerke J., Ringertz H., Silverman N. H., Brundage B., Botvinick E. H., Boswell R. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation. 1979 Sep;60(3):547–555. doi: 10.1161/01.cir.60.3.547. [DOI] [PubMed] [Google Scholar]
- ten Cate F. J., Kloster F. E., van Dorp W. G., Meester G. T., Relandt J. Dimensions and volumes of left atrium and ventricle determined by single beam echocardiography. Br Heart J. 1974 Aug;36(8):737–746. doi: 10.1136/hrt.36.8.737. [DOI] [PMC free article] [PubMed] [Google Scholar]