Kanji BANDO, Nobuo FUKUDA, Hisanori SHINOHARA, Naoki TAKEICHI, Takeshi SOEKI, Hideji TANAKA, Yoshiyuki TAMURA

Division of Cardiology and Clinical Research, Zentsuji National Hospital (2-1-1 Senyu-cho, Zentsuji-shi, Kagawa-ken 765-8507, Japan)

キーワード : Atrial fibrillation, Left atrial function, Pulmonary venous flow, Peak systolic forward flow, Transesophageal echocardiography

We attempted to evaluate the influence of left atrial function on left and right pulmonary venous flow velocity pattern using transesophageal echocardiography by comparing patients in sinus rhythm (SR) with those in atrial fibrillation (AF). The study group consisted of 36 patients with normal SR and 46 patients with AF in whom flow signals from both the left and right pulmonary veins could be clearly recorded in the left lateral decubitus position. We also recorded the pulmonary venous flow in 7 patients in SR and 8 in AF in the right lateral decubitus position. In the left lateral decubitus position, the SR group tended to have a peak systolic forward flow (peak S) velocity that was higher in the left than in the right pulmonary vein. In the AF group, however, peak S velocity was markedly higher in the left pulmonary vein than in the right pulmonary vein. The expansion fraction of the left atrium (LA) was significantly smaller in the AF group than in the SR group. In the right lateral decubitus position, the AF group demonstrated a peak S velocity that was significantly decreased in the left pulmonary vein, but was significantly increased in the right pulmonary vein. Peak S velocity in the SR group showed no significant change, however. These results suggest that peak systolic flow velocity of the pulmonary veins may be greatly influenced by changes in flow volume in patients with AF, but not in those with SR. This phenomenon may be induced by the absence of LA distensibility.