Left Atrium Volumn Index and Mitral Valve Regurgitation

[bzmed]

I recently saw a report on www.acc.org that was reporting on Left Atrium enlargement and they were dicussing the LA Vol Index.  They were stating that when this number exceeds 32 the risk of stroke and other problems rise significantly.

My question is are there specific recommedations on treatment when the LA Vol Index exceeds 32 on someone with mitral valve regurgitation?

Thank you for your help!

bzmed

[Forum-M.D.-bkj]

Bzmed,

Thanks for the post.

You are looking too closely at details. I never treat or make recommendations based on a specific echo or any other testing finding outside the context of the patient. While left atrial dilitation can be associated with stroke, this is generally in the setting of the underlying disease that caused the dilitation (ie...atrial fibrillation, mitral stenosis, mitral regurgitaition....). The key question is what is causing the atrial dilitation and what the treatment for that condition is. (ie....ablation, valve replacement, etc...)

good luck

[Momto3]

I don't know all the specifics, but I know that the volume index must be correlated clinically to your body size, type, etc.

Aften an echo last year, my report stated that "a volume in excess  of 32 cc/m2 is significantly abnormal," and mine wass 37 cc/m2.  I asked my doctor about the report and she said "According to the usual criteria, the left atrial size is normal. Only when they do a sophisticated volume measurement and adjust to your (low) weight does it come out a little large."  Anyway, it turned out to be just fine.  Hope you find the same result ; 0

connie

[bzmed]

Thanks Connie for your reply.

They did classify my left atrium as mild left atrium enlargement (in case that makes a difference in the reply).  Although the echo report states Left Atrial Enlargement with LA Vol Index of 33.1.

[Momto3]

My report also said left atrial enlargement. Last month, I was in for a cardiac consult and the EKG said the same thing....It's weird how those machines spit out "diagnoses."  I always feel much better after the doctor actually reviews the tape, etc.  Although the machines attempt to "diagnose" the doctor's interpretation is much more accurate.

How much does your valve leak?   I'm looking forward to the doctor's response as I always learn new things here.  

Have a great day!

[bzmed]

Sorry, I missed your question on this.  My regurg is moderate right now and the Left Atrium Enlargement was also confirmed via TEE by the doctor's inspection.

It looks like I have a hereditary connective tissue disorder which could be responsible for the initial prolapse.  My great-grandfather died of an aortic aneurism the year I was born.  My aortic root is near the upper limit of normal right now.

I've known I have the prolapse since my 20's but now the regurg is so loud at times it can be heard without a stethoscope.  I can even hear it and feel it quite a bit.  So now I think it is a wait and watch type thing.  My cardiologist put me on beta blocker and ACE inhibitor but took me off the ACE inhibitor last week due to low blood pressure with symptoms.  I go back to him next week for follow up.  Since that time - they have diagnosed the hereditary connective tissue disorder so I will have something new to tell him.  I think it will mean keeping an eye on the aortic root as well as regurg.  If I have to have one problem fixed I want to make sure we cover the other at the same time if it is necessary.

Thanks for the reply!