Assessment of left atrial appendage function and its relationship to pulmonary venous flow pattern by transesophageal echocardiography

We evaluated left atrial appendage function and its relationship to pulmona ry venous flow in 53 patients divided into four groups. Group 1 consisted o f 10 normal subjects. Group 2 included 15 patients with significant pure mi tral stenosis in sinus rhythm. In group 3, there were 13 patients with pure significant mitral stenosis and atrial fibrillation. Group 1 consisted of 15 patients with normal mitral valve and atrial fibrilltion. We found signi ficant decrease in left atrial appendage ejection fraction and maximum empt ying flow velocity, velocity time integral of systolic pulmonary venous flo w in Groups 2, 3 and 4 in comparison with normal subjects. Systolic pulmona ry venous how velocity was significantly decreased in Groups 3 and 4. There was significant correlation between left atrial appendage ejection fractio n and peak emptying flow velocity (r=0.62, P <0.001). Systolic peak pulmona ry venous flow velocity was significantly correlated with left atrial appen dage ejection fraction and maximum emptying flow velocity (r=0.67, P=0,01; r=0.58, P <0,001, respectively). There was also significant correlation bet ween systolic pulmonary venous flow velocity time integral and left atrial appendage ejection fraction (r=0.66, P=0.001). When normals were excluded f rom analysis, all the correlations were still significant. We concluded tha t left atrial appendage is a contractile structure, and that systolic pulmo nary venous flow velocity is influenced by left atrial appendage dysfunctio n. Therefore left atrial appendage function needs to be considered when int erpreting Doppler transmitral and systolic pulmonary venous Row patterns. ( C) 2001 Elsevier Science Ireland Ltd. All rights reserved.