Letter to the Editor
Postprandial left atrial filling is impaired in patients with large hiatal hernia and improves following surgical repair

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Conflict of interest

The authors report no relationships that could be construed as a conflict of interest.

Acknowledgments

The authors would like to thank Helen Lackey for her assistance with conducting the cardiac MRI studies.

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Cited by (8)

  • Chest Pain Imaging: Expect the Unexpected

    2019, Journal of Emergency Medicine
  • Feeding Induces Left Atrial Compression and Impedes Cardiac Filling in Patients With Large Hiatal Hernia

    2019, Journal of the American Society of Echocardiography
    Citation Excerpt :

    These effects were substantially but incompletely corrected by HH surgery, as our patients after HH repair still demonstrated altered cardiac reserve compared with young healthy people and with higher E/E′ and mitral inflow. We have previously demonstrated that feeding acutely increases HH volume and decreases LA volumes on cardiac magnetic resonance imaging.2 The greatest reductions in postprandial LA volumes were observed during the second half of LA reservoir filling and during active LA emptying.

  • Influence of large hiatus hernia on cardiac volumes. A prospective observational cohort study by cardiovascular magnetic resonance

    2018, International Journal of Cardiology
    Citation Excerpt :

    Most patients with large hiatus hernia (LHH) complain of symptoms such as postprandial dyspnea, tachycardia, chest discomfort or fatigue related to anemia due to occult bleeding [1]. Shortness of breath and arrhythmias, including atrial fibrillation or flutter, have long been associated to the compression of herniated stomach on the heart or lungs [2,3]. These cardiopulmonary symptoms may be reversible and elderly patients may benefit from LHH repair [4,5].

  • Posterior cardiac compression from a large hiatal hernia—A novel cause of ventricular tachycardia

    2018, HeartRhythm Case Reports
    Citation Excerpt :

    The obstructive effects of these hernias are further exacerbated by feeding and the Valsalva maneuver.2,3 This dynamic nature of cardiac compression has been demonstrated on cardiac magnetic resonance imaging, with feeding inducing an increase in hernia size and reduction in LA volumes.2 This is particularly relevant in our case, as the EPSs were performed fasting, which may have contributed to the noninducibility of the VT.

  • Large Hiatal Hernia Compressing the Heart

    2016, American Journal of Cardiology
    Citation Excerpt :

    Impingement of the left atrium, pulmonary veins, and coronary sinus can result in reduced cardiac output.5,6 A key diagnostic clue, although not present in our patient, is postprandial syncope resulting from a decrease in left atrial volumes after meals.7 Surgical repair of large hiatal hernia has been proved to significantly relieve symptoms,6–8 as seen in our patient.

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Grant support: This study was funded by an investigator-initiated research grant to CN from Pfizer (WS1899830), Australia, a post-graduate research scholarship to CN from the National Health and Medical Research Council (APP1039316) of Australia, and program grant funding to LK from the National Health and Medical Research Council (APP1037903) of Australia. The funding bodies had no role in study design, data collection, analysis or writing of the manuscript.

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