학술대회 발표 연제 초록

Left atrial maximal size (LAmax) has been suggested as an important marker which reflects left ventricular (LV) diastolic function. However, LAmax could be related to the mitral annular systolic motion which is affected by LV systolic function. We examined the value of LA size at late LA diastole (LApre-a) which is less affected by LV systolic function as compared with LAmax in predicting LV filling pressure in the setting of acutely impaired LV systolic function. Forty patients following acute myocardial infarction (MI) were enrolled in this study (age = 35~83, mean: 59.9, EF = 22~59%, mean: 45.9%). Maximal LA dimension (LADmax) and volume (LAVmax) were measured on parasternal M-mode image and apical 4 chamber plane. LA dimension and volume at late LA diastole were measured just before the onset of p wave on ECG (LADpre-a and LAVpre-a, respectively) within the 2.3days after MI. Peak E velocity of mitral inflow and peak E' velocity of septal mitral annulus were measured by conventional and tissue Doppler echocardiography. E/E' was used for the indirect measure of LV filling pressure. LADpre-a and LADmax as well as LAVpre-a and LAVmax were significantly related to E/E�� (r=0.53, p<0.001 for LADpre-a; r=0.57, p<0.001 for LADmax; r=0.38, p=0.01 for LAVpre-a; r=0.39, p=0.01 for LAVmax). According to the ROC curve analysis, LAmax and LApre-a showed comparable area under the curves (AUCs) in detecting the patients with E/E�� > 15 (0.812 for LADpre-a; 0.796 for LADmax; 0.712 for LAVpre-a; 0676 for LAVmax). LA size at late LA diastole can be used as an alternative to maximal LA size for the estimation of LV diastolic function in acute stage of myocardial infarction.