A study of analysis of LA modelling and pathophysiologic determinants of LA volume in patients with LV dysfunction in patients with dilated cardiomyopathy

 

 

Abstract              Background: Dilated cardiomyopathy represents the final common pathway produced by a variety of ischemic, toxic, metabolic and immunological mechanisms damaging the heart muscle. Recently, it has been shown that LA volume provides a more accurate measure of LA size than conventional M-mode LA dimension. Transthoracic echocardiography is most commonly used in daily clinical practice to assess LA size. Aim and objective: To analyze the degree of LA remodeling and the pathophysiologic determinants of LA volume in patients with LV systolic dysfunction in patients with dilated cardiomyopathy Methodology: Present prospective study was carried out on patients with a diagnosis of DCMP. Sex matched controls were recruited. The left atrial functions of the patients were evaluated by performing transthoracic echocardiography. The LV ejection fraction, LV volumes, and LV mass were determined. Mitral E-wave (E) and A-wave (A) velocities, E/A ratio, and E-wave deceleration time (DTE) is also measured off-line. Mitral regurgitation was assessed by color flow Doppler echocardiography. Data was analyzed with appropriate statistical tests. Results: Mean age of the study population was 36.08 ±16.13 years. Patients with DCM showed a larger LA volume (75.57 ± 27.60 ml,) compared with normal control subjects (58.57 ± 21.37 p < 0.016). Differences in the E-wave velocity (0.92 ± 0.25 vs. 1.07 ± 0.20; p <0.029), A-wave velocity (0.68 ± 0.32 vs. 0.82 ± 0.16 p < 0.066), E/A ratio (1.71 ± 0.90 vs. 1.30 ± 0.25 p < 0.05), or DT (165 ± 40.11 vs.197.25± 24.33 p <0.002) were observed between patients and control subjects. Em and LVEF were significant determinants of LA volume with p value of 0.03 and 0.01.

Key Word: dilated cardiomyopathy.