Left atrial mechanical function after cardioversion of atrial fibrillation estimation by pulmonary venous and transmitral flow velocity patterns

WS3-A-1-08 METABOUC CHANGES AND EFFECT OF LEUKOCYTE DEPLETION IN MYOCARDIAL ISCHEMIA-REPERFUSION S. Ohkubo and N. Takekoshi, Div. of Cardiol., Dept. of Internal Medicine, Kanazawa Medical Univ., Ishikawa, Japan This study was performed to assess the degree of simultaneous separation of malondialdehyde(MDA),ascorbic acid(AA), and adenosine nucleotide derivative from biological samples achievable with ion-pairing high-performance liquid chromatography. We evaluated the effects of leukocyte depletion in an ischemia-reperfusion study. Methods: Adult mongrel dogs (control(C):n=10; leukocyte deplstion(D):n=10) were anesthetized and the LAD was occluded for 60 min and then reperfused for 60 min during leukocyte dapletional extracorporeal perfusion. "13ssuesamples ware extracted from the reperfused portion by needle biopsy during the preischemic period, after 60 rain of ischemia and after 60 min of reperfusion. Regional myocardial blood flow was determined using colored rnicrosphsres. Results: Values of metabolism ware expressed as mean (p. moles/g dry wt.): MDA AA Ado ATP Ino Hypo Xan C:pre 0.012 0.67 0.04 25.9 0.008 0.06 0.052 D:pre 0.010 0.70 0.05 25.4 0.007 0.07 0.058 C:lh-occ 2.74 0.12 0.77 10.4 0.64 16.0 17.7 D:lh-occ 2.32 0.22* 0.62 17.5" 0.63 14.5 16.7 C:1 h-re 4.32 0.001 1.27 7.52 1.29 22.7 25.4 D:lh-re 3.59* 0.013" 1.17 16.7" 1.07" 21.7 21.7" ( occ:occlusion, re:reperfusion, Ado:adenosine, ATP:adenosine5'-triphosphate, Ino:inosine, Hypo:hypoxanthine, Xan:xanthine, *p<0.05:comparedwith control ) Conclusion: These results indicate that leukocytes have a great influence on metabolic injury induced by ischemia-reperfusion.

WS3-BI-I-01 LEFT ATRIAL MECHANICAL FUNCTION AFTER CARDIOVERSION OF ATRIAL FIBRIl J.ATION - ESTIMATION BY PULMONARY VENOUS AND TRANSM1TRAL FLOW VFX,OCrIN PATTERNS -

A. luchi, T. Oki, N. Fukuda, T. Ta&zta, Y. Kageji, K. Manabe, M. Sasaki, M. Hama, S. /to. Second Dep. of lnt. Med., School of Med., University of Tolatshima , Tokushima, $qpon Background and method : It has been reported that atrial component of the transmitral flow (TMF) was gradually increased after cardioversion of atrial fibrillation (AF). However, changes of atrial systolic backward and first systolic forward waves of pulmonary venous flow (PVF) after this procedure are not well known at present. To examine the time course of recovery of left atrial mechanical function after electric cardioversion of AF, we recorded PVF, TMF and interatrial septal motion during atrial systole (IAS-A) using transesophageal echocardiography in 15 normal controls(N), and immediately (Imm) and ten days after cardioversion in 20 patients with AF (6 with lone AF, 6 with hypertension, 5 with ischemic heart disease and 3 with dilated cardiomyopathy). Results : Immediately after cardioversion of AF, peak velocities of the atrial systolic waves of TMF and PVF (I'M-A and PV-A, respectively), sum of duration of both the atrial systolic waves (d-sum), peak velocity of the first systolic wave (PV-Sl) of PVF and IAS-A were smaller than those of N. However, these parameters were significantly increased ten days after cardioversion as compared with those immediately after cardioversion, excluding the three patients with dilated cardiomyopathy. Pulsed Doppler and M-mode Echocardiographic Variables TM-A(cnVs) PV-A(cm/s) d-sum(msec) PV-SI(cnYs)

N

IAS-A(mm)

47___ 5

23 4" 5

248-1-28

45__.15

5.4-+-0.9

Imm.

27-1-12 #

8.6__. 6 #

10 days

49+_.15"

20 -I-12"

170-1-39 # 252-t-44"

1 4-1-1 3 # 2.5-t-2.2 # 27-t-11 * 5.0-1-3.0" # p<0.01 vs N, * p<0.01 vs Imm.

AF

Conclusion : Active atrial systolic OWI-A and PV-A) and relaxant (PV-S0 parameters obtained from TMF and PVF could reflect well the left atrial mechanical function after cardioversion of AF.

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