Научно-практический журнал
«Клиническая физиология кровообращения»

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, президент ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» МЗ РФ


Каталог статей ➤ КФК. 2022; 19 (4): 287-392 ➤ Анатомия и функция левого предсердия: от диагностики к клинической практике

Анатомия и функция левого предсердия: от диагностики к клинической практике

Авторы: Кокшенева И.В., Капленко Л.И.

Организация:
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2022-19-4-302-313

УДК: 616.125.2-091

Библиографическая ссылка: Клиническая физиология кровообращения. 2022; 4 (19): 302-313

Цитировать как: Кокшенева И.В., Капленко Л.И. . Анатомия и функция левого предсердия: от диагностики к клинической практике. Клиническая физиология кровообращения. 2022; 4 (19): 302-313. DOI: 10.24022/1814-6910-2022-19-4-302-313

Ключевые слова: аортокоронарное шунтирование, недостаточность шунтов, кровотечения, антитромбоцитарные препараты, тромбоциты

Поступила / Принята к печати:  24.10.2022 / 16.12.2022

Полнотекстовая версия:  

Аннотация

Сегодня наблюдается переоценка роли левого предсердия (ЛП) в патогенезе симптомов и влиянии на прогноз сердечно-сосудистых заболеваний. Имеются обширные доказательные данные, свидетельствующие, что структурно-функциональные нарушения миокарда ЛП, которые возникают при многих сердечно-сосудистых заболеваниях, представляют собой мощный прогностический показатель. Согласно современным данным, ЛП в физиологии системной гемодинамики постепенно начинают рассматривать не как пассивную камеру, а как центральный и активный элемент общей гемодинамики. Анатомическая, механическая, гемодинамическая, электрофизиологическая и реологическая роль ЛП доказаны.
Статья представляет обзор исследований по анатомии, физиологии, особенностям ремоделирования и дисфункции ЛП, освещает современные диагностические подходы к оценке геометрии и функции левого предсердия. Рассматриваются информативность и прогностическая точность оценки геометрии и механической функции ЛП в прогнозировании негативных сердечно-сосудистых исходов.
В перспективе исследования по изучению проблемы левопредсердной дисфункции позволят улучшить диагностику, создадут основу для более глубокого понимания механизмов, лежащих в основе дисфункции ЛП, и разработки эффективных методов лечения.

Литература

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****
  1. Triposkiadis F., Pieske B., Butler J., Parissis J., Giamouzis G., Skoularigis J. et al. Global left atrial failure in heart failure. Еur. J. Heart Fail. 2016; 18: 1307–20. DOI: 10.1002/ejhf.645
  2. Bokeria L.A., Berishvili I.I. Surgical anatomy of the heart. Normal heart and physiology of blood circulation. In 3 vol. Moscow; 2006 (in Russ.).
  3. Aguero J., Galan-Arriola C., Fernandez-Jimenez R., Sanchez-Gonzalez J., Ajmone N., Delgado V. et al. Atrial infarction and ischemic mitral regurgitation contribute to post-MI remodeling of the left atrium. J. Am. Coll. Cardiol. 2017; 70: 2878–89. DOI: 10.1016/j.jacc.2017.10.013
  4. Álvarez-García J., Vives-Borrás M., Gomis P., OrdoñezLlanos J., Ferrero-Gregori A., Serra-Peñaranda A., Cinca J. Electrophysiological effects of selective atrial coronary artery occlusion in humans. Circulation. 2016; 133: 2235–42. DOI: 10.1161/CIRCULATIONAHA.116.021700.
  5. Harvey W. On the motion of the heart and blood in animals. In: Eliot C.W.: The Harvard Classics (1909–1914) 38. Part III. Collier, New York; Global Grey, 2018.
  6. Boudoulas K.D., Paraskevaidis I.A., Boudoulas H., Triposkiadis F.K. The left atrium: from the research laboratory to the clinic. Cardiology. 2014; 129 (1): 1–17. DOI: 10.1159/000360935
  7. Sirbu C., Herbots L., D'hooge J., Claus P., Marciniak A., Langeland T. et al. Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur. J. Echocardiogr. 2006; 7 (3): 199–208. DOI: 10.1016/j.euje.2005.06.001
  8. Shen M.J., Arora R., Jalife J. Atrial Myopathy. JACC: Basic. Transl. Sci. 2019; 5 (4): 640–54. DOI: 10.1016/j.jacbts.2019.05.005
  9. Singh A., Carvalho Singulane C., Miyoshi T., Prado A.D., Addetia K., Bellino M. et al. WASE Investigators. Normal values of left atrial size and function and the impact of age: results of the World Alliance Societies of Echocardiography Study. J. Am. Soc. Echocardiogr. 2022; 35 (2): 154–64.e3. DOI: 10.1016/j.echo.2021.08.008
  10. Badano L.P., Kolias T.J., Muraru D., Abraham T.P., Aurigemma G., Edvardsen T. et al. Industry representatives; Reviewers: This document was reviewed by members of the 2016-2018 EACVI Scientific Documents Committee. Standardization of left atrial, right ventricular, and right atrial deformation imaging using twodimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur. Heart. J. Cardiovasc. Imaging. 2018; 19 (6): 591–600. DOI: 10.1093/ehjci/jey042
  11. Wright S.P., Dawkins T.G., Eves N.D., Shave R., Tedford R.J., Mak S. Hemodynamic function of the right ventricular-pulmonary vascular-left atrial unit: normal responses to exercise in healthy adults. Am. J. Physiol. Heart. Circ. Physiol. 2021; 320 (3): H923–41. DOI: 10.1152/ajpheart.00720.2020
  12. Quiñones M.A., Greenberg B.H., Kopelen H.A., Koilpillai C., Limacher M.C., Shindler D.M. et al. Echocardiographic predictors of clinical outcome in patients with left ventricular dysfunction enrolled in the SOLVD registry and trials: significance of left ventricular hypertrophy. Studies of left ventricular dysfunction. J. Am. Coll. Cardiol. 2000; 35 (5): 1237–44. DOI: 10.1016/s0735-1097(00)00511-8
  13. Rossi A., Temporelli P.L., Quintana M., Dini F.L., Ghio S., Hillis G.S. et al. MeRGE Heart Failure Collaborators. Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta-analysis of longitudinal data (MeRGE Heart Failure). Eur. J. Heart. Fail. 2009; 11 (10): 929–36. DOI: 10.1093/eurjhf/hfp112
  14. Rossi A., Cicoira M., Zanolla L., Sandrini R., Golia G., Zardini P., Enriquez-Sarano M.J. Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. Am. Coll. Cardiol. 2002; 40 (8): 1425. DOI: 10.1016/s0735-1097(02)02305-7
  15. Modin D., Sengeløv M., Jørgensen P.G., Olsen F.J., Bruun N.E., Fritz-Hansen T. et al. Prognostic value of left atrial functional measures in heart failure with reduced ejection fraction. J. Card. Fail. 2019; 25 (2): 87–96. DOI: 10.1016/j.cardfail.2018.11.016.23
  16. Potter E.L., Ramkumar S., Kawakami H., Yang H., Wright L., Negishi T. et al. Association of asymptomatic diastolic dysfunction assessed by left atrial strain with incident heart failure. JACC Cardiovasc. Imaging. 2020; 13 (11): 2316–26. DOI: 10.1016/j.jcmg.2020.04.028
  17. Putko B.N., Savu A., Kaul P., Ezekowitz J., Dyck J.R., Anderson T.J. et al. Left atrial remodelling, mid-regional pro-atrial natriuretic peptide, and prognosis across a range of ejection fractions in heart failure. Eur. Heart J. Cardiovasc Imaging. 2021; 22 (2): 220–8. DOI: 10.1093/ehjci/jeaa041
  18. Bytycçi I., Dini F.L., Bajraktari A., Pugliese N.R., D'Agostino A., Bajraktari G. et al. Speckle tracking derived left atrial stiffness predicts clinical outcome in heart failure patients with reduced to mid-range ejection fraction. J. Clin. Med. 2020; 9 (5): 1244. DOI: 10.3390/jcm9051244
  19. Cameli M., Sciaccaluga C., Loiacono F., Simova I., Miglioranza M.H., Nistor D. et al. The analysis of left atrial function predicts the severity of functional impairment in chronic heart failure: The FLASH multicenter study. Int. J. Cardiol. 2019; 286: 87–91. DOI: 10.1016/j.ijcard.2019.03.063
  20. Welles C.C., Ku I.A., Kwan D.M., Whooley M.A., Schiller N.B., Turakhia M.P. Left atrial function predicts heart failure hospitalization in subjects with preserved ejection fraction and coronary heart disease: longitudinal data from the Heart and Soul Study. J. Am. Coll. Cardiol. 2012; 59 (7): 673–80. DOI: 10.1016/j.jacc.2011.11.012
  21. Santos A.B., Roca G.Q., Claggett B., Sweitzer N.K., Shah S.J., Anand I.S. et al. Prognostic relevance of left atrial dysfunction in heart failure with preserved ejection fraction. Circ. Heart Fail. 2016; 9 (4): e002763. DOI: 10.1161/CIRCHEARTFAILURE.115.002763
  22. Freed B.H., Daruwalla V., Cheng J.Y., Aguilar F.G., Beussink L., Choi A. et al. Prognostic utility and clinical significance of cardiac mechanics in heart failure with preserved ejection fraction: importance of left atrial strain. Circ. Cardiovasc. Imaging. 2016; 9 (3): e003754 DOI: 10.1161/CIRCIMAGING.115.003754
  23. Abbasi S.A., Shah R.V., McNulty S.E., Hernandez A.F., Semigran M.J., Lewis G.D. et al. Left atrial structure and function in heart failure with preserved ejection fraction: a RELAX Substudy. PLoS One. 2016; 11 (11): e0164914. DOI: 10.1371/journal.pone.0164914
  24. Reddy Y.N.V., Borlaug B.A. Left atrial myopathy in heart failure with preserved ejection fraction. Eur. J. Heart Fail. 2020; 22 (3): 486–8. DOI: 10.1002/ejhf.1688
  25. Greenberg J.W., Lancaster T.S., Schuessler R.B., Melby S.J. Postoperative atrial fibrillation following cardiac surgery: a persistent complication. Eur. J. Cardiothorac. Surg. 2017; 52 (4): 665–72. DOI: 10.1093/ejcts/ezx039
  26. Melduni R.M., Suri R.M., Seward J.B., Bailey K.R., Ammash N.M., Oh J.K. et al. Diastolic dysfunction in patients undergoing cardiac surgery: a pathophysiological mechanism underlying the initiation of new-onset post-operative atrial fibrillation. J. Am. Coll. Cardiol. 2011; 58 (9): 953–61. DOI: 10.1016/j.jacc.2011.05.021
  27. Tayyareci Y., Yildirimtürk O., Aytekin V., Memic K., Behramoglu F., Demiroglu I.C., Aytekin S. Preoperative left atrial mechanical dysfunction predicts postoperative atrial fibrillation after coronary artery bypass graft operation – a velocity vector imaging-based study. Circ. J. 2010; 74 (10): 2109–17. DOI: 10.1253/circj.cj-10-0197
  28. Her A.Y., Kim J.Y., Kim Y.H., Choi E.Y., Min P.K., Yoon Y.W. et al. Left atrial strain assessed by speckle tracking imaging is related to new-onset atrial fibrillation after coronary artery bypass grafting. Can. J. Cardiol. 2013; 29 (3): 377–83. DOI: 10.1016/j.cjca.2012.06.006
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Об авторах

  • Кокшенева Инна Валериевна, д-р мед. наук, ст. науч. сотр.; ORCID
  • Капленко Лидия Игоревна, аспирант; ORCID

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