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Published in: The International Journal of Cardiovascular Imaging 9/2019

01-09-2019 | Anemia | Original Paper

Evaluation of left atrial volume and function by real time three-dimensional echocardiography in anemic patients without overt heart disease before and after anemia correction

Authors: Seçkin Dereli, Adil Bayramoğlu, Nurtaç Özer, Sinan Cerşit, Ahmet Kaya, Muhammet Özbilen

Published in: The International Journal of Cardiovascular Imaging | Issue 9/2019

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Abstract

There are few data on the effects of low hemoglobine levels on the left atrium (LA) in anemic patients. Our aim was to evaluate left atrial (LA) volume and functions in anemic patients using real time three-dimensional echocardiography (RT3DE) and also to investigate changes in variables of LA after the correction of anemia. In total, 55 iron-deficiency anemia patients without traditional cardiovascular (CV) risk factors and 30 age- and gender-matched controls were studied. Assessments included history, physical examination and echocardiography. Of the 55 patients with anemia enrolled, 50 (39 females and 11 males 40.3 years) were followed and underwent echocardiography after correction of the anemia. LA maximum volume (LAVmax), LA minimal volume (LAVmin), LAVmax index (LAVI), before atrial contraction volume (LAVpreA), LA total emptying fraction, LA active emptying volume were higher in anemic patients. LA passive emptying fraction was significantly lower in anemic patients. Following correction of anemia, LA volume and function parameters were observed to be significantly reduced. Moreover, significant increase was noted in LA passive emptying fraction. Correlation analysis was performed and a significant negative correlation was noted between the percentage change in hemoglobin level and percentage change in LAVI (r = − 0.382, p = 0.003). It was shown that volume and functions of LA are impaired in anemic patients. However impaired parameters were improved after correction of anemia. It may be thought that RT3DE LA parameters can be used as an important preclinical marker of disease pathogenesis before developing heart failure or atrial arrhythmia.
Literature
1.
go back to reference Camaschella C (2015) Iron-deficiency anemia. N Engl J Med 373(5):485–486PubMed Camaschella C (2015) Iron-deficiency anemia. N Engl J Med 373(5):485–486PubMed
2.
go back to reference Felker GM et al (2004) Anemia as a risk factor and therapeutic target in heart failure. J Am Coll Cardiol 44(5):959–966CrossRefPubMed Felker GM et al (2004) Anemia as a risk factor and therapeutic target in heart failure. J Am Coll Cardiol 44(5):959–966CrossRefPubMed
3.
go back to reference Anand I et al (2004) Anemia and its relationship to clinical outcome in heart failure. Circulation 110(2):149–154CrossRefPubMed Anand I et al (2004) Anemia and its relationship to clinical outcome in heart failure. Circulation 110(2):149–154CrossRefPubMed
4.
go back to reference Sarnak MJ et al (2002) Anemia as a risk factor for cardiovascular disease in the atherosclerosis risk in communities (ARIC) study. J Am Coll Cardiol 40(1):27–33CrossRefPubMed Sarnak MJ et al (2002) Anemia as a risk factor for cardiovascular disease in the atherosclerosis risk in communities (ARIC) study. J Am Coll Cardiol 40(1):27–33CrossRefPubMed
5.
go back to reference Aessopos A et al (2004) Cardiovascular adaptation to chronic anemia in the elderly: an echocardiographic study. Clin Invest Med 27(5):265–274PubMed Aessopos A et al (2004) Cardiovascular adaptation to chronic anemia in the elderly: an echocardiographic study. Clin Invest Med 27(5):265–274PubMed
6.
go back to reference Rakusan K, Cicutti N, Kolar F (2001) Effect of anemia on cardiac function, microvascular structure, and capillary hematocrit in rat hearts. Am J Physiol Heart Circ Physiol 280(3):H1407–H1414CrossRefPubMed Rakusan K, Cicutti N, Kolar F (2001) Effect of anemia on cardiac function, microvascular structure, and capillary hematocrit in rat hearts. Am J Physiol Heart Circ Physiol 280(3):H1407–H1414CrossRefPubMed
7.
go back to reference Amin MG et al (2004) Hematocrit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol 43(7):1276–1282CrossRefPubMed Amin MG et al (2004) Hematocrit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol 43(7):1276–1282CrossRefPubMed
8.
go back to reference Srivastava PM et al (2008) Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes. Clin Sci 114(4):313–320CrossRefPubMed Srivastava PM et al (2008) Prevalence and predictors of cardiac hypertrophy and dysfunction in patients with Type 2 diabetes. Clin Sci 114(4):313–320CrossRefPubMed
9.
go back to reference Nair D et al (2005) Association of anemia with diastolic dysfunction among patients with coronary artery disease in the Heart and Soul Study. Am J Cardiol 95(3):332–336CrossRefPubMedPubMedCentral Nair D et al (2005) Association of anemia with diastolic dysfunction among patients with coronary artery disease in the Heart and Soul Study. Am J Cardiol 95(3):332–336CrossRefPubMedPubMedCentral
10.
go back to reference Bahl V et al (1992) Noninvasive assessment of systolic and diastolic left ventricular function in patients with chronic severe anemia: a combined M-mode, two-dimensional, and Doppler echocardiographic study. Am Heart J 124(6):1516–1523CrossRefPubMed Bahl V et al (1992) Noninvasive assessment of systolic and diastolic left ventricular function in patients with chronic severe anemia: a combined M-mode, two-dimensional, and Doppler echocardiographic study. Am Heart J 124(6):1516–1523CrossRefPubMed
11.
go back to reference Pasricha S-R et al (2013) Control of iron deficiency anemia in low and middle-income countries. Blood 121:2607–2617CrossRefPubMed Pasricha S-R et al (2013) Control of iron deficiency anemia in low and middle-income countries. Blood 121:2607–2617CrossRefPubMed
12.
go back to reference Lin Q et al (2013) Left atrial minimum volume by real-time three-dimensional echocardiography as an indicator of diastolic dysfunction. Chin Med J 126(22):4227–4231PubMed Lin Q et al (2013) Left atrial minimum volume by real-time three-dimensional echocardiography as an indicator of diastolic dysfunction. Chin Med J 126(22):4227–4231PubMed
13.
go back to reference Cho I-J et al (2014) Effect of anemia correction on left ventricular structure and filling pressure in anemic patients without overt heart disease. Korean J Internal Med 29(4):445CrossRef Cho I-J et al (2014) Effect of anemia correction on left ventricular structure and filling pressure in anemic patients without overt heart disease. Korean J Internal Med 29(4):445CrossRef
14.
go back to reference Møller JE et al (2003) Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation 107(17):2207–2212CrossRefPubMed Møller JE et al (2003) Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation 107(17):2207–2212CrossRefPubMed
15.
go back to reference Osranek M et al (2006) Left atrial volume predicts the risk of atrial fibrillation after cardiac surgery: a prospective study. J Am Coll Cardiol 48(4):779–786CrossRefPubMed Osranek M et al (2006) Left atrial volume predicts the risk of atrial fibrillation after cardiac surgery: a prospective study. J Am Coll Cardiol 48(4):779–786CrossRefPubMed
16.
go back to reference Modena MG et al (1997) Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: a long-term follow-up study. Clin Cardiol 20(6):553–560CrossRefPubMed Modena MG et al (1997) Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: a long-term follow-up study. Clin Cardiol 20(6):553–560CrossRefPubMed
17.
go back to reference Tsang TS et al (2002) Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 90(12):1284–1289CrossRefPubMed Tsang TS et al (2002) Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 90(12):1284–1289CrossRefPubMed
18.
go back to reference Lester SJ et al (1999) Best method in clinical practice and in research studies to determine left atrial size. Am J Cardiol 84(7):829–832CrossRefPubMed Lester SJ et al (1999) Best method in clinical practice and in research studies to determine left atrial size. Am J Cardiol 84(7):829–832CrossRefPubMed
19.
go back to reference Gopal AS et al (1993) Left ventricular volume and endocardial surface area by three-dimensional echocardiography: comparison with two-dimensional echocardiography and nuclear magnetic resonance imaging in normal subjects. J Am Coll Cardiol 22(1):258–270CrossRefPubMed Gopal AS et al (1993) Left ventricular volume and endocardial surface area by three-dimensional echocardiography: comparison with two-dimensional echocardiography and nuclear magnetic resonance imaging in normal subjects. J Am Coll Cardiol 22(1):258–270CrossRefPubMed
20.
go back to reference Aktürk E et al (2012) Left atrial volume and function in patients with Behcet's disease assessed by real-time three-dimensional echocardiography. Eur Heart J Cardiovas Imaging 13(8):650–655CrossRef Aktürk E et al (2012) Left atrial volume and function in patients with Behcet's disease assessed by real-time three-dimensional echocardiography. Eur Heart J Cardiovas Imaging 13(8):650–655CrossRef
21.
go back to reference Aktürk E et al (2012) Early left atrial mechanics and volume abnormalities in subjects with prehypertension: a real time three-dimensional echocardiography study. Echocardiography 29(10):1211–1217CrossRefPubMed Aktürk E et al (2012) Early left atrial mechanics and volume abnormalities in subjects with prehypertension: a real time three-dimensional echocardiography study. Echocardiography 29(10):1211–1217CrossRefPubMed
22.
go back to reference Nagueh SF et al (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur J Echocardiogr 17(12):1321–1360 Nagueh SF et al (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur J Echocardiogr 17(12):1321–1360
23.
go back to reference Lang RM et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16(3):233–271CrossRefPubMed Lang RM et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16(3):233–271CrossRefPubMed
24.
go back to reference Lupu S, Mitre A, Dobreanu D (2014) Left atrium function assessment by echocardiography –physiological and clinical implications. Med Ultrasonogr 16(2):152–159CrossRef Lupu S, Mitre A, Dobreanu D (2014) Left atrium function assessment by echocardiography –physiological and clinical implications. Med Ultrasonogr 16(2):152–159CrossRef
25.
go back to reference Anwar AM et al (2008) Assessment of left atrial volume and function by real-time three-dimensional echocardiography. Int J Cardiol 123(2):155–161CrossRefPubMed Anwar AM et al (2008) Assessment of left atrial volume and function by real-time three-dimensional echocardiography. Int J Cardiol 123(2):155–161CrossRefPubMed
27.
go back to reference Georgieva Z, Georgieva M (1997) Compensatory and adaptive changes in microcirculation and left ventricular function of patients with chronic iron-deficiency anaemia. Clin Hemorheol Microcirc 17(1):21–30PubMed Georgieva Z, Georgieva M (1997) Compensatory and adaptive changes in microcirculation and left ventricular function of patients with chronic iron-deficiency anaemia. Clin Hemorheol Microcirc 17(1):21–30PubMed
28.
go back to reference Komajda M et al (2006) The impact of new onset anaemia on morbidity and mortality in chronic heart failure: results from COMET. Eur Heart J 27(12):1440–1446CrossRefPubMed Komajda M et al (2006) The impact of new onset anaemia on morbidity and mortality in chronic heart failure: results from COMET. Eur Heart J 27(12):1440–1446CrossRefPubMed
29.
go back to reference Kaitha S, Bashir M, Ali T (2015) Iron deficiency anemia in inflammatory bowel disease. World J Gastrointestinal Pathophysiol 6(3):62CrossRef Kaitha S, Bashir M, Ali T (2015) Iron deficiency anemia in inflammatory bowel disease. World J Gastrointestinal Pathophysiol 6(3):62CrossRef
30.
go back to reference Shen J et al (2015) Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography. Cardiovasc Ultrasound 14(1):34CrossRef Shen J et al (2015) Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography. Cardiovasc Ultrasound 14(1):34CrossRef
31.
go back to reference Tsang TS et al (2006) Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol 47(5):1018–1023CrossRefPubMed Tsang TS et al (2006) Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol 47(5):1018–1023CrossRefPubMed
32.
go back to reference Laukkanen JA et al (2005) Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med 165(15):1788–1793CrossRefPubMed Laukkanen JA et al (2005) Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med 165(15):1788–1793CrossRefPubMed
33.
go back to reference Otani K et al (2010) Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 23(9):961–967CrossRefPubMed Otani K et al (2010) Impact of diastolic dysfunction grade on left atrial mechanics assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr 23(9):961–967CrossRefPubMed
35.
go back to reference Triposkiadis F et al (1995) Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr 8(6):801–809CrossRefPubMed Triposkiadis F et al (1995) Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr 8(6):801–809CrossRefPubMed
36.
go back to reference Anwar AM et al (2007) Assessment of left atrial ejection force in hypertrophic cardiomyopathy using real-time three-dimensional echocardiography. J Am Soc Echocardiogr 20(6):744–748CrossRefPubMed Anwar AM et al (2007) Assessment of left atrial ejection force in hypertrophic cardiomyopathy using real-time three-dimensional echocardiography. J Am Soc Echocardiogr 20(6):744–748CrossRefPubMed
37.
go back to reference Hsiao S-H, Chiou K-R (2013) Left atrial expansion index predicts atrial fibrillation in dyspnea. Circ J 77(11):2712–2721CrossRefPubMed Hsiao S-H, Chiou K-R (2013) Left atrial expansion index predicts atrial fibrillation in dyspnea. Circ J 77(11):2712–2721CrossRefPubMed
38.
go back to reference Metivier F et al (2000) Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dialysis Transplant 15:14–18CrossRef Metivier F et al (2000) Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dialysis Transplant 15:14–18CrossRef
Metadata
Title
Evaluation of left atrial volume and function by real time three-dimensional echocardiography in anemic patients without overt heart disease before and after anemia correction
Authors
Seçkin Dereli
Adil Bayramoğlu
Nurtaç Özer
Sinan Cerşit
Ahmet Kaya
Muhammet Özbilen
Publication date
01-09-2019
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 9/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-019-01609-6

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