Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Int J Cardiovasc Imaging. 2022 Oct;38(10):2155-2165. doi: 10.1007/s10554-022-02614-y. Epub 2022 Apr 23.
Left atrial (LA) inflow propagation velocity from the pulmonary vein (LAIF-PV) has been proposed as a novel measure of LA reservoir function and is associated with pulmonary capillary wedge pressure in critically ill patients. However, data on LAIF-PV in acute heart failure (AHF) are lacking. We sought to examine the feasibility of measuring LAIF-PV and evaluate clinical and echocardiographic correlates of LAIF-PV in AHF. In a prospective cohort study of adults hospitalized for AHF, we used color M-mode Doppler of the pulmonary veins to obtain LAIF-PV in systole. Among 142 patients with appropriate images and no more than moderate mitral regurgitation, LAIF-PV measures were feasible in 76 patients (54%) aged 71 ± 14 years, including 68% men with left ventricular ejection fraction (LVEF) 38% ± 13. Mean LAIF-PV was 24.2 ± 5.9 cm/s. In multivariable regression analysis adjusted for age, sex, systolic blood pressure, heart rate, body mass index, New York Heart Association class, LA volume and LVEF, the only independent echocardiographic predictors of LAIF-PV were right ventricular (RV) S' [ß 0.46 cm/s per cm/s (95% CI 0.01-0.91), p = 0.045] and tricuspid annular plane systolic excursion (TAPSE) [ß 0.28 cm/s per mm (95% CI 0.02-0.54), p = 0.039]. Notably, LAIF-PV was not significantly correlated with measures of LV function, LA function or E/e'. In conclusion, LAIF-PV was measurable in 54% of patients with AHF, and lower values were associated with measures of impaired RV systolic function but not LV or LA function.
左心房（LA）从肺静脉（LAIF-PV）的流入速度已被提议作为 LA 储器功能的新测量方法，并且与危重病患者的肺毛细血管楔压相关。然而，关于急性心力衰竭（AHF）中的 LAIF-PV 数据缺乏。我们试图检查测量 LAIF-PV 的可行性，并评估 AHF 中 LAIF-PV 的临床和超声心动图相关性。在一项对因 AHF 住院的成年人的前瞻性队列研究中，我们使用彩色 M 模式多普勒超声心动图获得了收缩期的 LAIF-PV。在 142 名图像合适且二尖瓣反流不超过中度的患者中，76 名患者（54％）的 LAIF-PV 测量值可行，这些患者年龄为 71±14 岁，其中 68％为男性，左心室射血分数（LVEF）为 38％±13。平均 LAIF-PV 为 24.2±5.9cm/s。在多变量回归分析中，校正年龄、性别、收缩压、心率、体重指数、纽约心脏协会（NYHA）分级、LA 容积和 LVEF 后，唯一独立的超声心动图预测 LAIF-PV 的因素是右心室（RV）S'[每厘米/秒 0.46cm/s（95％CI 0.01-0.91），p=0.045]和三尖瓣环平面收缩期位移（TAPSE）[每毫米 0.28cm/s（95％CI 0.02-0.54），p=0.039]。值得注意的是，LAIF-PV 与 LV 功能、LA 功能或 E/e'的测量值无显著相关性。总之，在 54％的 AHF 患者中可以测量 LAIF-PV，并且较低的值与 RV 收缩功能受损的测量值相关，而与 LV 或 LA 功能无关。
