左房拡大

WordNet

toward or on the left; also used figuratively; "he looked right and left"; "the political party has moved left"
a turn toward the side of the body that is on the north when the person is facing east; "take a left at the corner"
the hand that is on the left side of the body; "jab with your left" (同)left_hand
those who support varying degrees of social or political or economic change designed to promote the public welfare (同)left wing
location near or direction toward the left side; i.e. the side to the north when a person or object faces east; "she stood on the left"
intended for the left hand; "I rarely lose a left-hand glove" (同)left-hand
being or located on or directed toward the side of the body to the west when facing north; "my left hand"; "left center field"; "the left bank of a river is bank on your left side when you are facing downstream"
of or belonging to the political or intellectual left
the state of being enlarged
a photographic print that has been enlarged (同)blowup, magnification
of or relating to a cavity or chamber in the body (especially one of the upper chambers of the heart)

PrepTutorEJDIC

leaveの過去・過去分詞
《名詞の前にのみ用いて》『左の』,左方の / 《しばしばl-》(政治上の)左翼の,左派の,革新派の / 左に,左方に / 《通例 the ~》『左』,左方,左側 / 《しばしばthe L-》左翼の政党(団体),左派 / 〈U〉(野球で)左翼,レフト(left field);〈C〉左翼手(left fielder) / 〈C〉(ボクシングで)左手打ち
〈U〉〈C〉拡大,増大,拡張;増補;増築 / 〈C〉拡大(増大,拡張)された部分 / 〈C〉(写真)の引き伸ばし;引き伸ばした写真

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/04 22:22:11」(JST)

wiki en

Left atrial enlargement (LAE) or left atrial dilation refers to enlargement of the left atrium (LA) of the heart, and is a form of cardiomegaly.

Causes

In the general population, obesity appears to be the most important risk factor for LAE.^[1] LAE has been found to be correlated to body size, independent of obesity, meaning that LAE is more common in people with a naturally large body size. ^[2] Also, a study found that LAE can occur as a consequence of atrial fibrillation (AF),^[3] although another study found that AF by itself does not cause LAE. The latter study also showed that the persistent type of AF was associated with LAE, but the number of years that a subject had AF was not.^[4]

Obstructive sleep apnea (OSA) may be a cause of LAE in some cases. When an OSA event occurs, there is an attempt to breathe with an obstructed airway and the pressure inside the chest is suddenly lowered. The negative intrathoracic pressure may cause the left atrium to expand and stretch its walls during each OSA event. Over time, the repetitive stretching of the left atrium may result in a persistent left atrial enlargement.^[5]

Clinical implications

Although other factors may contribute, left atrium size has been found to be a predictor of mortality due to both cardiovascular issues as well as all-cause mortality. Current research suggests that left atrium size as measured by an echo-cardiograph may have prognostic implications for preclinical cardiovascular disease. However, studies that have found LAE to be a predictor for mortality recognize the need for more standardized left atrium measurements than those found in an echo-cardiogram. ^[2]

Diagnosis

LAE is suggested by an electrocardiogram (ECG) that has a pronounced notch in the P wave.^[6] However, if there is atrial fibrillation, a P wave would not be present.^[7] In any case, LAE can be diagnosed and measured using an echocardiogram (ECHO).

Characterizing the size of the left atrium according to its volume is preferred over a single linear dimension since enlargement can be different for different directions. For example, because of the smaller distance in the thoracic cavity between the sternum and spine, compared to the other directions, there is less room for enlargement of the left atrium along the anteroposterior axis.^[8] By approximating the shape of the left atrium as an ellipsoid, its volume can be calculated from measurements of its dimensions along three perpendicular directions.^[3]

Indexing the left atrial volume to body surface area (volume/BSA) is recommended by the American Society of Echocardiography and the European Association of Echocardiography. The values for volume/BSA in the following table are the ones that are the best validated and are the same for both men and women.^[8]

	normal	enlarged			normal	enlarged
Left Atrium Size^[8]	Women				Men
	normal	mild	moderate	severe	normal	mild	moderate	severe
Diameter (mm)	27–38	39–42	43–46	≥47	30–40	41–46	47–52	≥52
Volume (ml)	22–52	53–62	63–72	≥73	18–58	59–68	69–78	≥79
Volume/BSA (ml/m²)	16–28	29–33	34–39	≥40	16–28	29–33	34–39	≥40
BSA, body surface area

References

^ Stritzke J, Markus MRP, Duderstadt S, Lieb W, Luchner A, Döring A, Keil U, Hense H and Schunkert H (2009-11-17). "The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging: The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study". Journal of the American College of Cardiology 54 (21): 1982–9. doi:10.1016/j.jacc.2009.07.034. PMID 19909880. Retrieved 2009-12-02.
^ ^a ^b Patel DA, Lavie CJ, Milani RV, Shah S, Giliand Y. (Winter 2009). "Clinical Implications of Left Atrial Enlargement: A Review". The Ochsner Journal 9 (4): 191–196. PMC 3096293. PMID 21603443.
^ ^a ^b Sanfilippo AJ, Abascal VM, Sheehan M, Oertel LB, Harrigan P, Hughes RA and Weyman AE (1990). "Atrial enlargement as a consequence of atrial fibrillation A prospective echocardiographic study". Circulation 82 (3): 792–7. doi:10.1161/01.CIR.82.3.792. PMID 2144217. Retrieved 2009-12-02.
^ Osranek M, Bursi F, Bailey KR, Grossardt BR, Brown RD Jr, Kopecky SL, Tsang TS and Seward JB. (Dec 2005). "Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up". European Heart Journal 26 (23): 2556–61. doi:10.1093/eurheartj/ehi483. PMID 16141257. Retrieved 2009-12-27. See p. 2560 Left ventricular filling pressure, LAV, and AF.
^ Latina JM, Estes III NAM, Garlitski AC (2013). "The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay". Pulmonary Medicine 2013 (621736): 1–11. doi:10.1155/2013/621736. PMC 3600315. PMID 23533751. Retrieved 2014-08-11. See section 5.1.
^ Edhouse J, Thakur RK, Khalil JM (2002-05-25). "ABC of clinical electrocardiography. Conditions affecting the left side of the heart.". British Medical Journal 324 (7348): 1264–7. doi:10.1136/bmj.324.7348.1264. PMC 1123219. PMID 12028984. Retrieved 2010-06-18.
^ "Atrial Fibrillation (for Professionals)". American Heart Association, Inc. 2008-12-04. Archived from the original on 2009-03-28.
^ ^a ^b ^c Lang, RM; Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W (March 2006). "Recommendations for chamber quantification". European Journal of Echocardiography 7 (2): 79–108. doi:10.1016/j.euje.2005.12.014. PMID 16458610. Retrieved 2012-08-26.

UpToDate Contents

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1. 心電図チュートリアル：心室拡大および心室肥大 ecg tutorial chamber enlargement and hypertrophy
2. 慢性僧帽弁閉鎖不全症のマネージメントの概要 overview of the management of chronic mitral regurgitation
3. 心耳の心エコー評価 echocardiographic evaluation of the atria and appendages
4. 正常洞調律および洞性不整脈 normal sinus rhythm and sinus arrhythmia
5. 心房細動における心エコー検査の役割 role of echocardiography in atrial fibrillation

English Journal

Left atrial dilatation is associated with severe ischemic stroke in men with non-valvular atrial fibrillation.

Kim TW1, Jung SW1, Song IU1, Koo J1, Choi HS2, Lee KS1, Park JW1, Park HJ3, Kim JS4.
Journal of the neurological sciences.J Neurol Sci.2015 Jul 15;354(1-2):97-102. doi: 10.1016/j.jns.2015.05.008. Epub 2015 May 13.
BACKGROUND: Increased left atrial volume is an independent predictive factor of first ischemic stroke and other cardiovascular events in patients with non-valvular atrial fibrillation (NVAF). However, correlations between left atrial dilatation and ischemic stroke severity or ischemic lesion pattern
PMID 26001853

Small interfering RNA therapy against carbohydrate sulfotransferase 15 inhibits cardiac remodeling in rats with dilated cardiomyopathy.

Watanabe K1, Arumugam S2, Sreedhar R2, Thandavarayan RA3, Nakamura T2, Nakamura M4, Harima M2, Yoneyama H5, Suzuki K6.
Cellular signalling.Cell Signal.2015 Jul;27(7):1517-24. doi: 10.1016/j.cellsig.2015.03.004. Epub 2015 Mar 14.
Carbohydrate sulfotransferase 15 (CHST15) is a sulfotransferase responsible for biosynthesis of chondroitin sulfate E (CS-E), which plays important roles in numerous biological events such as biosynthesis of proinflammatory cytokines. However, the effects of CHST15 siRNA in rats with chronic heart f
PMID 25778904

Serum cystatin C level is associated with left atrial enlargement, left ventricular hypertrophy and impaired left ventricular relaxation in patients with stage 2 or 3 chronic kidney disease.

Sakuragi S1, Ichikawa K2, Yamada K2, Tanimoto M2, Miki T2, Otsuka H2, Yamamoto K2, Kawamoto K2, Katayama Y2, Tanakaya M2, Ito H3.
International journal of cardiology.Int J Cardiol.2015 Jul 1;190:287-92. doi: 10.1016/j.ijcard.2015.04.189. Epub 2015 Apr 24.
BACKGROUND: Cystatin C is an endogenous marker of kidney function that overcomes the limitations of serum creatinine. High serum cystatin C levels have been associated with increased cardiovascular mortality and morbidity. In this cross-sectional study, we aimed to determine the associations between
PMID 25932809

Japanese Journal

著しい筋力低下を認めたACTH 非依存性両側副腎皮質大結節性過形成（AIMAH）の一例

山田穂高,佐々木正美,浅野智子,青木厚,生駒亜希,豊島秀男,加計正文,川上正舒,石川三衛
自治医科大学紀要 = Jichi Medical University Journal 35, 101-105, 2013-03-00
… A local physician noted bilateral adrenal enlargement on an abdominal CT scan. … Because of this patient's serious concurrent conditions, including paroxysmal atrial fibrillation and herpes zoster, adrenalectomy was not possible during this hospitalization. … The present case illustrates that AIMAH left undiagnosed for a long period produces muscular atrophy and reduces anti-inflammatory activity. …
NAID 120005295173

Peri-Atrial Epicardial Adipose Tissue Is Associated With New-Onset Nonvalvular Atrial Fibrillation

NAKANISHI Koki,FUKUDA Shota,TANAKA Atsushi,OTSUKA Kenichiro,SAKAMOTO Makoto,TAGUCHI Haruyuki,YOSHIKAWA Junichi,SHIMADA Kenei,YOSHIYAMA Minoru
Circulation journal : official journal of the Japanese Circulation Society 76(12), 2748-2754, 2012-11-25
… Background: Atrial fibrillation (AF) is associated with considerable morbidity and mortality in patients with coronary artery disease (CAD). … Epicardial adipose tissue (EAT) is recognized as an important inflammatory tissue that may exert deleterious effects on the adjacent left atrial (LA) wall. … This study used MDCT to investigate the effect of peri-atrial EAT on new-onset nonvalvular AF. …
NAID 10031126044

筋エコーにより筋炎の関与が判明した右房拡張症の一例

宮崎由道,高松直子,宮城愛,寺澤由佳,松井尚子,浅沼光太郎,和泉唯信,梶龍兒
神経超音波医学 = Neurosonology : official journal of Japan Academy of Neurosonology 24(1), 12-14, 2011-10-30
… Electrocardiography demonstrated atrial fibrillation associated with marked dilation of the right atrium. … Magnetic resonance imaging of the heart showed marked dilation of the right atrium, as well as diffuse high-intensity areas in the left ventricle in T2-weighted images.We diagnosed the patient as having generalized myositis associated with myocarditis, and administered steroid therapy. …
NAID 10030395108

Related Pictures

★リンクテーブル★

リンク元	「左房拡大」
関連記事	「left」「atrial」「enlargement」「left atrial」

「左房拡大」

　　[★]

英: left atrial enlargement
関: 左房負荷、左房

心電図の読み方パーフェクトマニュアルp.27

僧帽性P：I,IIのいずれか：P波の幅：3mm以上
左心性P：V1：前半陽性、後半陰性の二相性：[P terminal force]Pの陰性部分の幅(秒で計測)x深さ(mmで計測)≧0.04mm･秒　(あるいは 0.04s = 1mmのプロットならば Pの陰性部分の幅(mmで計測)x深さ(mmで計測)≧1mm²)

[P terminal force] = [Pの陰性部分の幅](秒で計測)x[深さ](mmで計測)≧0.04mm･秒

= [Pの陰性部分の幅](mmで計測)x[深さ](mmで計測)≧1mm²

僧帽性Pと左心性P 心電図の読み方パーフェクトマニュアル p.69

IIでは右房と左房の起電力をとらえられる(僧帽性P)のに対し、V1では左房が左後方に後方にあるが故陰性の起電力としてとらえられ2相性(左心性P)となる。

左房拡大がみられる疾患心電図の読み方パーフェクトマニュアル p.69

MS, MR, 2次性(HTによるLVH, 心筋症)

「left」

　　[★]

adj.

左の、左方の

n.

左、

v.

(leaveの過去-過去分詞として)去る

関: leave

「atrial」

　　[★]

adj.

心房性の、心房の

関: atria、atrium、heart atria、heart atrium

「enlargement」

　　[★]

n.

拡大、増大、拡張、増補、増築

「left atrial」

　　[★]

左心房の

関: left atria、left atrium

[Stritzke2009-1] Stritzke J, Markus MRP, Duderstadt S, Lieb W, Luchner A, Döring A, Keil U, Hense H and Schunkert H (2009-11-17). "The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging: The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study". Journal of the American College of Cardiology 54 (21): 1982–9. doi:10.1016/j.jacc.2009.07.034. PMID 19909880. Retrieved 2009-12-02.

[Patel2009-2] Patel DA, Lavie CJ, Milani RV, Shah S, Giliand Y. (Winter 2009). "Clinical Implications of Left Atrial Enlargement: A Review". The Ochsner Journal 9 (4): 191–196. PMC 3096293. PMID 21603443.

[Sanfilippo1990-3] Sanfilippo AJ, Abascal VM, Sheehan M, Oertel LB, Harrigan P, Hughes RA and Weyman AE (1990). "Atrial enlargement as a consequence of atrial fibrillation A prospective echocardiographic study". Circulation 82 (3): 792–7. doi:10.1161/01.CIR.82.3.792. PMID 2144217. Retrieved 2009-12-02.

[Osranek2005-4] Osranek M, Bursi F, Bailey KR, Grossardt BR, Brown RD Jr, Kopecky SL, Tsang TS and Seward JB. (Dec 2005). "Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up". European Heart Journal 26 (23): 2556–61. doi:10.1093/eurheartj/ehi483. PMID 16141257. Retrieved 2009-12-27. See p. 2560 Left ventricular filling pressure, LAV, and AF.

[Latina2013-5] Latina JM, Estes III NAM, Garlitski AC (2013). "The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay". Pulmonary Medicine 2013 (621736): 1–11. doi:10.1155/2013/621736. PMC 3600315. PMID 23533751. Retrieved 2014-08-11. See section 5.1.

[Edhouse2002-6] Edhouse J, Thakur RK, Khalil JM (2002-05-25). "ABC of clinical electrocardiography. Conditions affecting the left side of the heart.". British Medical Journal 324 (7348): 1264–7. doi:10.1136/bmj.324.7348.1264. PMC 1123219. PMID 12028984. Retrieved 2010-06-18.

[AHAafibForProfessionals-7] "Atrial Fibrillation (for Professionals)". American Heart Association, Inc. 2008-12-04. Archived from the original on 2009-03-28.

[Lang2006-8] Lang, RM; Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W (March 2006). "Recommendations for chamber quantification". European Journal of Echocardiography 7 (2): 79–108. doi:10.1016/j.euje.2005.12.014. PMID 16458610. Retrieved 2012-08-26.

匿名

検索

案内

案内

left atrial enlargement

WordNet

PrepTutorEJDIC

Wikipedia preview

wiki en

Contents

Causes

Clinical implications

Diagnosis

References

UpToDate Contents

English Journal

Japanese Journal

Related Links

Related Pictures

★リンクテーブル★

「左房拡大」

心電図の読み方パーフェクトマニュアルp.27

僧帽性Pと左心性P 心電図の読み方パーフェクトマニュアル p.69

左房拡大がみられる疾患心電図の読み方パーフェクトマニュアル p.69

「left」

「atrial」

「enlargement」

「left atrial」

匿名

検索

案内

left atrial enlargement

WordNet

PrepTutorEJDIC

Wikipedia preview

wiki en

Contents

Causes

Clinical implications

Diagnosis

References

UpToDate Contents

English Journal

Japanese Journal

Related Links

Related Pictures

★リンクテーブル★

「左房拡大」

心電図の読み方パーフェクトマニュアルp.27

僧帽性Pと左心性P 心電図の読み方パーフェクトマニュアル p.69

左房拡大がみられる疾患 心電図の読み方パーフェクトマニュアル p.69

「left」

「atrial」

「enlargement」

「left atrial」

左房拡大がみられる疾患心電図の読み方パーフェクトマニュアル p.69