A hitherto study of relationship between left atrial volume and pressure in echocardiogram and length of left atrial branch of left circumflex artery in rheumatic heart disease

摘要

Background and objective: To study whether there is a relationshipbetween left atrial volume and pressure in echocardiogram and thelength of left atrial branch of LCX in coronary angiogram inpatients with RHD.Materials and methods: In our observational study of 52 patientswith rheumatic heart disease planned for valve replacement forwhom preoperative coronary angiogram was done were observedover a period of 2 years from June 2013 to May 2015. Left atrialindexed volume was calculated by area biplane method and leftatrial pressure was estimated by echocardiogram using the formulaIVRT/T(E-Ea). Length of atrial branch of LCX was measured incoronary angiogram.Inclusion criteria: (1) age 40–60 years; (2) patients of rheumaticheart disease with moderate to severe lesion planned for valvereplacement in sinus rhythm for whom perioperative CAG wasdone. Exclusion criteria: (1) Hypertension; (2) Coronary artery disease;(3) Atrial fibrillation.Results: Totally 52 patients of rheumatic heart disease were studiedof which 31 cases were females (60%) and 21 were males (40%).Mean age was 50 10 years. The indexed LA volume was highestfor mitral stenosis patients with a mean of 67.7, followed bypatients with MS/MR of 50.7, and MR patients of 44.7, and thenAS/AR of 33.08. The LA pressure/PCWP was categorized as 15.Of these 21 patients (40%) had PCWP 15 of which maximum number of patients were thosewith MS/MR followed by those with MS. The Left atrial branchlength ranged from 4.0 to 18.3 cm. On further analysis of the lengthit was found that 73%of MS patients had a length of >15 cm, 52% ofpatients with MS/MR had a length between 10 and 15 cm, 73% ofMR patients had a length between 5 and 10 cm and 80% of AS/ARpatients had a length <5 cm.