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Tissue Doppler echocardiographic evidence of atrial mechanical dysfunction in coronary artery disease

Cheuk-Man Yu1, Jeffrey Wing-Hon Fung, Qing Zhang

  • 1Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. cmyu@cuhk.edu.hk

International Journal of Cardiology
|October 26, 2005
PubMed

Insights

Coronary artery disease (CAD) impairs atrial contractile function, particularly in the left atrium. Tissue Doppler echocardiography (TDI) effectively detects this dysfunction, even in early stages.

Area of Science:

  • Cardiology
  • Cardiac Physiology
  • Echocardiography

Background:

  • Atrial function is crucial for overall cardiac performance but often overlooked.
  • Coronary artery disease (CAD) can negatively impact atrial function.
  • This study aimed to evaluate atrial mechanical dysfunction in CAD patients using tissue Doppler echocardiography (TDI).

Purpose of the Study:

  • To investigate the presence and extent of atrial mechanical dysfunction in patients with coronary artery disease (CAD).
  • To compare atrial function in CAD patients with healthy controls using tissue Doppler echocardiography (TDI).
  • To assess regional atrial function in the left atrium (LA), right atrium (RA), and inter-atrial septum (IAS).

Main Methods:

  • Echocardiography with TDI was performed on 118 CAD patients and 100 controls.
  • Regional atrial function was assessed by measuring peak regional atrial contraction velocity (V(A)) and mechanical event timing.
  • Comparisons were made between CAD patients and controls, as well as within subgroups based on systolic and diastolic function.

Main Results:

  • Patients with CAD exhibited significantly decreased V(A) in the LA, IAS, and RA compared to controls (p<0.001).
  • Impaired systolic function (ejection fraction ≤50%) and restrictive filling patterns (RFP) were associated with further reductions in V(A).
  • TDI detected abnormalities even in patients with preserved systolic function or mild diastolic dysfunction, unlike transmitral velocity measurements.

Conclusions:

  • Atrial contractile function is impaired in both atria of patients with CAD, with a more pronounced effect on the LA.
  • TDI is a sensitive method for detecting atrial mechanical dysfunction in CAD, even in early stages.
  • Direct assessment of atrial velocity by TDI provides a more accurate reflection of atrial mechanical function than transmitral atrial velocity.
Abstract

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