TIME-INTERVAL DETERMINATION FROM LEFT ATRIAL APPENDAGE EJECTION FLOW IN PATIENTS WITH MITRAL-STENOSIS

The feasibility of determining the time interval from left atrial appe ndage (LAA) flow was examined using transesophageal Doppler echocardio graphy. Time intervals were compared between LAA flow and mitral flow patterns during late diastole in 8 patients with mitral stenosis and i n 12 controls. The start of ejection flow from the LAA was later than the initiation of mitral flow, but the termination was same in both fl ows, indicating the contribution of LAA ejection to the latter half of the left atrial booster pump function. The pre-ejection time and the time interval from P-wave to end-ejection correlated significantly wit h left atrial dimensions (r = 0.55, and r = 0.70, respectively). The p re-ejection time, duration of the ejection flow from the LAA, and dura tion of mitral flow in the atrial contraction phase were significantly longer in patients with mitral stenosis (126 +/- 14 msec, 131 +/- 36 msec, and 167 +/- 28 msec, respectively) than in the controls (109 +/- 13 msec, 108 +/- 15 msec, and 141 +/- 17 msec, respectively). These r esults indicate that electrical conduction time from the right atrium to LAA can be estimated from the LAA ejection flow, and the time is re lated to the left atrial size. In patients with mitral stenosis, LAA c ontraction may contribute to left ventricular filling in the latter ha lf of the atrial contraction phase. (C) 1997 John Wiley & Sons, Inc.