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Doppler echocardiographic mitral and pulmonary venous flow-velocity pattern for assessment of LA function in patients with acute coronary syndromes.

Grzegorz Piotrowski, Aleksander Goch, Zenon Gawor, Jan H. Goch
Klinika Kardiologii Instytut Medycyny Wewnętrznej WAM, Łódź

The mitral and pulmonary venous flow-velocity pattern by means of transthoracic Doppler echocardiography was determined in 60 patients (pts) with acute coronary syndromes (ACS) (15 women and 45 men, aged [± SD] 60 ± 11) in the first hours of coronary instability and 10 days after. Mitral flow measurements included early (E) and atrial (A) velocities, deceleration time of E wave (DT). In pulmonary venous flow systolic (S), diastolic (D) and atrial reversal (Ar) velocities were measured. A and Ar described left atrium (LA) as a pump, S as a reservoir, and E, DT and D as a conduit.
The results showed the decrease of LA pump function after 10 days (A - 0,77 ± 0,19 vs 0,68 ± 0,14 m/s, p<0,05; Ar - 0,32 ± 0,09 vs 0,26 ± 0,05 m/s, p<0,05), the increase of LA reservoir function (S - 0,63 ± 0,17 vs 0,55 ± 0,09 m/s, p<0,05). Parameters determining LA conduit function did not change identically. S and DT decreased significantly (S-0,63 ± 0,17 vs 0,55 ± 0,09 m/s, p<0,05; DT - 227,6 ± 56,6 vs 198,9 ± 41,9 ms, p<0,05) while E did not change significantly (E-0,58 ± 0,22 vs 0,59 ± 0,14 m/s, p>0,05).
Our findings suggest that left ventricular function deterioration due to ischemia in pts with ACS is followed in first hours of coronary instability by a reduction of LA function as a reservoir and improvement of LA function as a pump as well as, as a conduit.








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