A bedside ultrasound sign of cardiac disease: the left atrium-to-aorta diastolic diameter ratio

• Published in: The American journal of emergency medicine 2010-02, Vol.28 (2), p.203-207
• Main Authors: Kimura, Bruce J., MD, Kedar, Eyal, MD, Weiss, Danielle E., MD, Wahlstrom, Casey L., RDCS, Agan, Donna L., EdD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aorta - diagnostic imaging; Biological and medical sciences; Cardiovascular disease; Confidence intervals; Echocardiography - methods; Emergency; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency medical care; Heart Atria - diagnostic imaging; Heart Diseases - diagnostic imaging; Humans; Intensive care medicine; Least-Squares Analysis; Medical sciences; Middle Aged; Organ Size; Point-of-Care Systems; Pulmonary arteries; Sensitivity and Specificity; Studies
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2008.10.006

Abstract Purpose This study evaluated a simple ultrasound method to detect left atrial (LA) enlargement by comparing the diameters of the LA and aortic root. Procedures The LA and aortic diameters, the LA volume index (LAVI), and significant echo findings were analyzed in 101 consecutive echocardiograms. Mean LAVI and the prevalence of an abnormal echo were compared between groups in which the ratio of the LA diameter to aortic diameter in diastole was >1 vs ≤1. Findings Left atrial-to-aortic diameter ratio increased with LAVI ( r = 0.64, P < .001). Left atrial-to-aortic diameter ratio >1 vs ≤1 was noted in 45% vs 55% of patients and had a mean (±SD) LAVI = 39 ± 12 vs 27 ± 7 mL/m2 ( P < .001) and a 78% vs 43% prevalence of an abnormal echo ( P < .001). Conclusion The left atrium-to-aorta diastolic diameter ratio can detect LA enlargement and may be useful as a quick bedside technique to screen for cardiac disease.