Circulation, Vol 67, 566-571, Copyright © 1983 by American Heart Association
Y Matsuda, Y Toma, H Ogawa, M Matsuzaki, K Katayama, T Fujii, F Yoshino, K Moritani, T Kumada and R Kusukawa
Left atrial function was evaluated in patients with and without remote
myocardial infarction. The simultaneous left atrial pressure recording and
left atrial and left ventricular cineangiograms were obtained with a
catheter-tip micromanometer. The pressure-volume curve of the left atrium
was composed of an A-loop and a V-loop. The ratio of active atrial emptying
to left ventricular stroke volume in patients with myocardial infarction
was significantly larger than that in normal subjects (42 +/- 12% vs 29 +/-
10%, p less than 0.05). The left atrial work was also significantly greater
in patients with myocardial infarction (1690 +/- 717 mm Hg X ml) than in
normal subjects (940 +/- 426 mm Hg X ml, p less than 0.05). The ratio of
active atrial emptying to left ventricular stroke volume and left atrial
work were significantly related in both normal subjects and patients with
myocardial infarction (gamma = 0.72, p less than 0.01). The left
ventricular ejection fraction correlated inversely with left atrial work
(gamma = -0.5, p less than 0.05). Left atrial work also showed a
significant linear correlation with left atrial volume before active atrial
emptying (gamma = 0.82, p less than 0.01). We conclude that the left atrial
contribution to left ventricular function is increased in patients with
remote myocardial infarction. This left atrial contribution to the left
ventricle is attributed to the Frank-Starling mechanism in the left atrium.
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Importance of left atrial function in patients with myocardial infarction
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