ABC | Volume 112, Nº3, March 2019

Original Article Baroncini et al Right ventricle and left atrial volume Arq Bras Cardiol. 2019; 112(3):249-257 Table 1 – Baseline characteristics of the study population Variable Classification Group p-value* Control (n = 25) Study (n = 25) Age (years) Mean ± DP 49.9 ± 16.3 67.1 ± 10.6 < 0.001 Sex Male 13 (52%) 10 (40%) Female 12 (48%) 15 (60%) 0.571 SAH No 17 (68%) 5 (20%) Yes 8 (32%) 20 (80%) 0.001 DM No 23 (92%) 18 (72%) Yes 2 (8%) 7 (28%) 0.138 Dyslipidemia No 21 (84%) 18 (72%) Yes 4 (16%) 7 (28%) 0.496 CAD No 25 (100%) 23 (92%) Yes 0 (0) 2 (8%) 0.490 Smoking No 22 (88%) 21 (84%) Yes 3 (12%) 4 (16%) 1 Results expressed as mean ± standard deviation (SD) or frequency and percentage. * Student’s t-test for independent samples (age); Fisher’s exact test (categorical variables); p < 0.05. SAH: systemic arterial hypertension; DM: diabetes mellitus; CAD: coronary artery disease Table 2 – Baseline echocardiographic parameters in the study group and the control group Variable Group n Mean ± standard deviation p-value* RV TAPSE (mm) Control 25 22.3 ± 2.0 Study 25 21.2 ± 2.6 0.103 RV lateral S' (cm/s) Control 25 13.7 ± 1.8 Study 25 13.2 ± 1.7 0.295 RVDD (mm) Control 25 20.9 ± 2.7 Study 25 22.0 ± 3.2 0.219 Left atrial size (mm) Control 25 33.5 ± 5.1 Study 25 37.3 ± 5.5 0.016 Left atrial volume (ml/m²) Control 25 29.2 ± 5.5 Study 25 30.3 ± 6.7 0.508 * Student’s t-test for independent samples, p < 0.05; RV: right ventricular; TAPSE: tricuspid annular plane systolic excursion with M-mode; RVDD: right ventricular diastolic diameter. lateral S’ of the right ventricle with LAV and size. A LAV > 34 mL/m 2 and left atrial size > 40 mm were associated with lower absolute values of TAPSE and RV lateral S’ (p ≤ 0.001, r= -0.4 and -0.38, respectively). There was a strong positive correlation of TAPSE with RV lateral S’ (r = 0.70, p < 0.001), and of LAV and left atrial size (r = 0.89, p < 0.01) (Tables 5 and 6, Figures 1 and 2). Discussion The role of the LAV as a sensitive index that reflects the severity of LV diastolic function and that provides prognostic information in many heart diseases has been well documented. 4 However, its possible effect on RV performance still requires research. The present study demonstrated a significative inverse correlation of LAV and left atrial size with absolute values of TAPSE and RV lateral S’ in patients with LVDD. In a similar study by Torii et al., 12 239 patients with atrial fibrillation (AF) were compared with 281 individuals with sinus rhythm; AF patients showed lower TAPSE values regardless of age, sex, heart rate, LV ejection fraction and tricuspid regurgitation velocity. No correlations were made with LAV or left atrial size. Since we did not include patients with AF, it is possible to infer that an enlarged LA, per se, affects TAPSE and RV lateral S’ only. It is known that left atrial enlargement does not occur uniformly due to physical limitations imposed by the sternum and spine, which can also affect dilatation and motion of the other cardiac chambers. 4 TAPSE reflects not only the shortening of RV free wall, but also the traction 251