LEFT ATRIAL VOLUME INDEX (LAVI) IN THE EVALUATION OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION

Although cardiac performance is traditionally focused on Ejection fraction an index of systolic function, diastolic function has been found to play an important role in morbidity and mortality. Diastolic heart failure constitutes about 20-40% admissions of heart failure. Left atrium is directly exposed to LV pressures in diastole. Chronic sustained elevation of elevated diastolic filling pressures result in left atrial remodeling resulting in its enlargement. Traditionally left atrial size is determined from the parasternal long axis view at end systole. However the left atrial volume is a better measure of LA size and provides better prognostic value. The influence of body surface area is corrected by dividing LA volume by body surface area to get LA volume index (LAVI). The normal value for all age groups is 22 +/- 6 ml/m. 1 AIM: To measure the left atrial volume and diastolic function in 60 subjects and to study the correlation between left atrial volume and diastolic dysfunction METHODS: 60 subjects (40 with diastolic dysfunction and 20 controls) referred to the echocardiography were studied. All subjects underwent trans thoracic echocardiography and Doppler imaging Diastolic filling was categorized as normal (grade 0) impaired relaxation (grade 1), pseudo normal pattern (grade 2), restrictive filling (grade 3). LA volume is measured by biplane area length method and indexed to BSA (LAVI) Results: Among diastolic dysfunction group, 25(62.5%) had Grade 1 diastolic dysfunction, 6(15%) have grade 2 and 9(22.5%) had grade3 diastolic dysfunction. Progressive increase in LAVI was seen with increasing severity of diastolic dysfunction. Mean LAVI in normal persons was 23.49 +/- 4.009 ml/sqm and in patients with diastolic dysfunction, it was 29.38 +/- 4.45, 39.44 +/- 8.19, 44.33 +/- 5.54 ml/sqm in grade 1, grade2 and grade3 diastolic dysfunctions groups respectively.