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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Mechanical function of left atrium and pulmonary vein sleeves before and after their antrum isolation

Department of Arrhythmology and Pacing, Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
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Medicina 2014, 50(6), 353-359; https://doi.org/10.1016/j.medici.2014.11.008
Received: 9 April 2014 / Accepted: 10 November 2014 / Published: 28 November 2014
Background and objective: Pulmonary vein (PV) sleeves are established as the main substrate taking part in the mechanisms of atrial fibrillation (AF) initiation. However, we have extremely few data concerning their physiological role in the heart contractility. The aim of the study was to estimate the mechanical function of the left atrium (LA) and PV sleeves before and early after their isolation.
Materials and methods: A total of 17 patients with a mean age of 57.4 ± 8.3 years who underwent PVs isolation due to AF were enrolled in the study. A day before the procedure a computed tomography (CT) of the LA and PVs and dopplerography of transmitral flow were performed. During the procedure the mechanical function of the LA and PV sleeves were estimated by transesophageal echocardiography and manometry in the left heart chambers.
Results: During the invasive study the patterns of the heart chambers and PV sleeves pressure were identified. These patterns confirmed the active role of the PV sleeves in LA filling and active LA relaxation during left ventricular systole. After PV isolation an alteration of transmitral blood flow and increase of LA pressure were registered. However, diastolic dysfunction was ruled out by LV manometry, thereby testifying LA mechanical function disturbance. The change in PV hemodynamics also occurred as a result of the decrease in PV sleeves contractility, revealed by manometry and paired CT scans.
Conclusions: The PVs take an active part in left atrial filling by contraction of their sleeves. Antrum isolation of the PVs leads to the deterioration of their contractility and LA reservoir function.
Keywords: Atrial contractility; Pulmonary vein isolation; Pulmonary vein sleeves Atrial contractility; Pulmonary vein isolation; Pulmonary vein sleeves
MDPI and ACS Style

Mamchur, S.; Mamchur, I.; Khomenko, E.; Kokov, A.; Bokhan, N.; Sherbinina, D. Mechanical function of left atrium and pulmonary vein sleeves before and after their antrum isolation. Medicina 2014, 50, 353-359.

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