Evaluation of left atrial function by the functional volume change curve derived from Doppler flow spectra

The objective of this study was to clarify the left atrial (LA) reservoir a nd booster pump function in patients with left ventricular (LV) diastolic d ysfunction. To determine LA reservoir and booster pump function, a new algo rithm to determine LA functional volume change curve (FVC) was developed fr om Doppler flow spectra of pulmonary venous flow and LV inflow by transthor acic echocardiography in 110 patients. Patients were classified into normal (N), and abnormal (AB) and pseudonormal (PN) groups on the basis of their Doppler flow patterns. From the indices of FVC, atrial reservoir volume (AR V), passive emptying volume (PEV) and active emptying volume (AEV) were obt ained. ARV/stroke volume (SV) was increased in the AB group, but decreased in the PN group compared with N (N, 0.61 +/-0.09; AB, 0.73 +/-0.10; PN, 0.5 2 +/-0.13, p<0.05). PEV/SV was significantly decreased in AB, but increased in PN compared with N (N, 0.27<plus/minus>0.07; AB, 0.19 +/-0.07; PN, 0.31 +/-0.18, p<0.05). AEV/SV was significantly increased in AB, but decreased in PN compared with N (N, 0.41<plus/minus>0.08; AB, 0.56 +/-0.10. PN, 0.26 +/-0.19, p<0.05). Thus, in patients with an abnormal relaxation pattern, th e LA reservoir and booster pump function are augmented, but in patients wit h a pseudonormal pattern, both LA reservoir and booster pump function are d eteriorated, suggesting a vulnerability to pulmonary congestion.