Left Atrial Volumes and Function in Normal Subjects

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Abstract
Left atrial (LA) emptying is biphasic; however, little information exists about the distribution of active and passive LA emptying. LA volumes and function were studied in 11 normal subjects with echocardiography using the biplane area length method. The LA volumes - maximal, at mitral valve opening; minimal, at mitral valve closure, and at onset of atrial systole (P wave on electrocardiogram) - were 46 ± 12, 29 ± 12, and 18 ± 7 cm^3, respectively. The LA passive emptying volume (maximal minus at P wave) was 17 ± 4 cm3, and the passive emptying fraction (passive emptying volume/maximal volume) was 0.39 ± 0.10. The LA active emptying volume (volume at P wave minus minimal) was 11 ± 5 cm^3, and the active emptying fraction (active emptying volume/volume at P wave) was 0.38 ± 0.07. The LA total emptying volume (maximal minus minimal) was 28 ± 5 cm^3, and the total emptying fraction (total emptying volume/maximal volume) was 0.62 ± 0.07. LA total emptying and active emptying volumes were directly related to LA maximal volume (r = 0.95) and volume at onset of atrial systole (r = 0.92), while LA passive emptying volume was not related to LA maximal volume. The study provides a framework for the evaluation of LA function and will help in understanding not only LA function, but also diastolic left ventricular function in health and disease states.

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