Pressure-Volume Relation of the Left Atrium in Man

  • Michio Arakawa
  • Tsutomu Tanaka
  • Senri Hirakawa


The reservoir function of the left atrium is important in producing an appropriate driving pressure and in providing an appropriate amount of blood for the following ventricular rapid filling.

To quantify this reservoir function in terms of the compliance, we simultaneously measured left atrial volume with biplane cineangiography and left atrial pressure, and reconstructed the pressure-volume relation in 10 patients with normal cardiac function. We tested the hypothesis that the pressure-volume relation of the left atrium during the ascending limb of the v-loop is largely a passive state. For this purpose, we observed whether the pressure-volume relation could be described as an exponential function (p = b·eaV: p, pressure; a and b, constants; V, Volume) which is widely accepted to describe the passive filling characteristics of the left ventricle in diastole.

The correlation coefficient of the regression equation was 0.96 ± 0.04 (mean ± SD), indicating that the strength of the relationship is great between the pressure and volume and that the slope of this regression line is gentle at low pressure and is steeper at high pressure. The left atrial compliance at the pressure of the peak v-wave (13.5 ± 3.6 mmHg) was 1.03 ± 0.26 ml·mmHg-1·m-.

We conclude that the pressure-volume relation is curvilinear during the ascending limb of the v-loop and that the reservoir function of the left atrium appears to be relatively small.


Mitral Valve Left Atrium Left Atrial Volume Left Atrial Pressure Atrial Contraction 
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  1. 1.
    Nathan H, Eliakim M (1966) The junction between the left atrium and the pulmonary veins: An anatomic study of human hearts. Circulation 34: 412–422PubMedGoogle Scholar
  2. 2.
    Williams JF Jr, Sonnenblick EH, Braunwald E (1965) Determinants of atrial contractile force in the intact heart. Am J Physiol 209: 1061–1068PubMedGoogle Scholar
  3. 3.
    Matsuda Y, Torna Y, Ogawa H, Matsuzaki M, Katayama K, Fujii T, Yoshino F, Moritani K, Kumada T, Kusukawa R (1983) Importance of left atrial function in patients with myocardial infarction. Circulation 67: 566–571PubMedCrossRefGoogle Scholar
  4. 4.
    Yamaguchi M, Arakawa M, Tanaka T, Takaya T, Nagano T, Hirakawa S (1987) Study on left atrial contractile performance: Participation of Frank-Starling mechanism. Jpn Cire J 51: 1001–1009CrossRefGoogle Scholar
  5. 5.
    Gaasch WH, Cole JS, Quinones MA, Alexander JK (1975) Dynamic determinants of left ventricular diastolic pressure-volume relations in man. Circulation 51: 317–323PubMedGoogle Scholar
  6. 6.
    Sutterer WF, Swan HJC, Wood EH (1957) Minimal dynamic response requirements of manometer systems for recording left atrial and ventricular pressures in man. Physiologist 1: 81Google Scholar
  7. 7.
    Krovetz LT, Goldbloom SD (1974) Frequency content of intravascular and intracardiac pressures and their time derivatives. IEEE Trans Biomed Eng 21: 489–501CrossRefGoogle Scholar
  8. 8.
    Sauter HJ, Dodge HT, Johnston RR, Graham TP (1964) The relationship of left atrial pressure and volume in patients with heart disease. Am Heart J 67: 635–642PubMedCrossRefGoogle Scholar
  9. 9.
    Baxley WA, Kennedy JW, Feild B, Dodge HT (1973) Hemodynamics in ruptured chordae tendineae and chronic rheumatic mitral regurgitation. Circulation 48: 1288–1294PubMedGoogle Scholar
  10. 10.
    Liu CK, Piccirillo RT, Ellestad M (1964) Distensibility of the postmortem human left atrium in nonrheumatic and rheumatic heart disease. Am J Cardiol 7: 232–238CrossRefGoogle Scholar
  11. 11.
    Nakajima K, Iizuka M, Natsume T, Sakaguchi A, Shibata H, Shimomura K, Ikeda M (1982) Assessment of left atrial stiffness in man. Circulation (Suppl II) 66: 327Google Scholar
  12. 12.
    Kajiya F, Wada Y, Ogasahara Y, Hiramatsu O, Mito K, Kagiyama M, Matsuoka S, Tsujioka K, Goto M (1988) Measurement of blood flow in the atrial artery and vein using laser Doppler velocimeter. (abstract) Jpn J Med Electr Biol Eng 26 (Suppl): 390 (in Japanese)Google Scholar
  13. 13.
    White CW, Kerber RE, Weiss HR, Marcus ML (1982) The effects of atrial fibrillation on atrial pressure-volume and flow relationships. Circ Res 51: 205–215PubMedGoogle Scholar
  14. 14.
    Kalmanson D, Veyrat C, Chiche P (1971) Atrial versus ventricular contribution in determining systolic venous return: A new approach to an old riddle. Cardiovasc Res 5: 293–302PubMedCrossRefGoogle Scholar
  15. 15.
    Keren G, Sherez J, Megidish R, Levitt B, Laniado S (1985) Pulmonary venous flow pattern—its relationship to cardiac dynamics: A pulsed Doppler echocardiography study. Circulation 71: 1105–1112PubMedCrossRefGoogle Scholar
  16. 16.
    Keren G, Bier A, Sherez J, Miura D, Keefe D, LeJemtel T (1986) Atrial contraction is an important determinant of pulmonary venous flow. J Am Coll Cardiol 7: 693–695PubMedCrossRefGoogle Scholar
  17. 17.
    Weisfeldt ML, Scully HE, Frederiksen J, Rubenstein JJ, Pohost GM, Beierholm E, Bello AG, Daggett WM (1974) Hemodynamic determinants of maximum negative dP/dt and periods of diastole. Am J Physiol 227: 613–621PubMedGoogle Scholar
  18. 18.
    Toma Y, Matsuda Y, Moritani K, Ogawa H, Matsuzaki M, Kusukawa R (1987) Left atrial filling in normal human subjects: Relation between left atrial contraction and left atrial early filling. Cardiovasc Res 21: 255–259PubMedCrossRefGoogle Scholar
  19. 19.
    Holt JP, Rohde EA, Kines H (1960) Pericardial and ventricular pressure. Circ Res 8: 1171–1181PubMedGoogle Scholar
  20. 20.
    Smiseth OA, Frais MA, Kingma I, White AM, Knudtson ML, Cohen JM, Manyari DE, Smith ER, Tyberg JV (1986) Assessment of pericardial constraint: The relation between right ventricular filling pressure and pericardial pressure measured after pericardiocentesis. J Am Coll Cardiol 7: 307–314PubMedCrossRefGoogle Scholar
  21. 21.
    David D, Michelson EL, Naito M, Chen CC, Schaffenburg M, Dreifus LS (1983) Diastolic “locking” of the mitral valve: the importance of atrial systole and intraventricular volume. Circulation 67: 640–645PubMedCrossRefGoogle Scholar
  22. 22.
    Arakawa M, Nagano T, Takaya T, Noda T, Miwa H, Kagawa K, Tanaka T, Yamaguchi M, Hirakawa S (1987) Diastolic compliance of the left atrium in man: A challenging concept as a determinant of preload of the left ventricle. Automedica 9: 120Google Scholar

Copyright information

© Springer-Verlag Tokyo 1989

Authors and Affiliations

  • Michio Arakawa
  • Tsutomu Tanaka
  • Senri Hirakawa
    • 1
  1. 1.The Second Department of Internal MedicineGifu University School of MedicineGifuJapan

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