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Left atrial and right atrial deformation in patients with coronary artery disease: a velocity vector imaging-based
Ping Yan1, Bin Sun, Haiming Shi
1Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, PR China.
Insights
Coronary artery disease (CAD) patients show altered atrial function, with decreased left atrial strain and increased right atrial strain. Left anterior descending artery stenosis specifically impacts left atrial strain, indicating potential diagnostic markers.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Coronary artery disease (CAD) is linked to impaired left ventricular (LV) function.
- Strain rate (SR) imaging has previously identified LV dysfunction in CAD patients.
Purpose of the Study:
- To investigate global and regional, systolic and diastolic left atrial (LA) and right atrial (RA) longitudinal deformation in CAD.
- Utilize velocity vector imaging (VVI) to assess atrial function in CAD.
Main Methods:
- Echocardiography and VVI performed on 20 mild CAD, 40 severe CAD patients, and 25 controls.
- Measured maximal atrial volume, peak atrial longitudinal strain (ε(s)), and SR during LV systole (SRs), early filling (SRe), and late filling (SRa).
- Calculated longitudinal strain during atrial contraction (ε(a)) and the ratio ε(a)/ε(s).
Main Results:
- CAD patients exhibited a trend towards decreased LA peak ε(s) and SRs.
- Global and lateral LA SRe were significantly lower in CAD groups compared to controls.
- RA ε(a), SRa, and ε(a)/ε(s) were significantly higher in CAD groups versus controls.
- LA SRa and ε(a)/ε(s) were significantly increased in patients with isolated left anterior descending (LAD) coronary artery stenosis.
Conclusions:
- CAD patients with preserved LVEF and borderline E/E' showed reduced LA SRe and increased RA ε(a), SRa, and ε(a)/ε(s).
- LAD stenosis was associated with significantly increased LA SRa and ε(a)/ε(s).
- Atrial deformation analysis using VVI may reveal subclinical cardiac dysfunction in CAD.
Background:
Impaired left ventricular (LV) function has been shown by strain rate (SR) imaging in patients with coronary artery disease (CAD). Our aim was to investigate global and regional, systolic and diastolic left atrial (LA) and right atrial (RA) longitudinal deformation in CAD using velocity vector imaging.
Methods:
Echocardiographic and velocity vector imaging studies were performed in 20 patients with mild CAD, 40 patients with severe CAD and 25 controls. Maximal atrial volume, peak atrial longitudinal strain (ε(s)) and SR during LV systole (SRs), SR during early LV filling (SRe) and late LV filling (SRa) were measured. Longitudinal strain during atrial contraction (ε(a)) was obtained at the onset of P-wave on electrocardiography, and ε(a)/ε(s) was calculated.
Results:
Longitudinal peak ε(s) and SRs of LA showed decreased trend among CAD patients. The global and lateral LA SRe were prominently lower, while RA ε(a), SRa and ε(a)/ε(s) were prominently higher in 2 CAD groups than control group (P value <0.05). As compared with controls and patients with other single-vessel disease, LA SRa and ε(a)/ε(s) ratio were significantly increased among patients with exclusively left anterior descending coronary artery (LAD) stenosis (SRa 1.14±0.38 s(-1), 1.10±0.41 s(-1), 1.45±0.46 s(-1), P value<0.05; ε(a)/ε(s) 0.44±0.11, 0.44±0.20, 0.57±0.12, P value<0.01).
Conclusions:
Apparently decreased SRe of LA and increased ε(a), SRa and ε(a)/ε(s) of RA were found in CAD patients with preserved LVEF and E/E' in gray zone. SRa and ε(a)/ε(s) of LA were found to significantly increase in those with LAD stenosis.
