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Updated: May 9, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Evaluation of biatrial size and functions by different echocardiographic parameters in patients with acute coronary
Mesut Pinar1, Okan Gulel, Zafer Kucuksu
1Cardiology Department, Evliya Celebi Hospital, Dumlupinar University, Kutahya, Turkey.
Insights
Acute coronary syndromes (ACS) significantly alter atrial size and function, increasing cardiovascular risk. Echocardiography reveals enlarged atria and impaired function in ACS patients compared to healthy individuals, highlighting the need for atrial assessment.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Echocardiography
Background:
- Cardiac remodeling post-acute coronary syndromes (ACS) affects atria, increasing adverse cardiovascular event risk.
- Atrial size and function evaluation are often underestimated in ACS patients.
Purpose of the Study:
- To compare left and right atrial size and function in ACS patients versus healthy controls.
- To utilize transthoracic echocardiography, including diameter, area, volume, and pulsed-wave tissue Doppler imaging (TDI).
Main Methods:
- 150 ACS patients (STEMI/non-STEMI) and 25 healthy controls underwent echocardiography.
- Biatrial dimensions, areas, and volumes were measured.
- Atrial emptying fraction, expansion index, and TDI velocities (S', E', A') were calculated.
Main Results:
- ACS patients exhibited larger left and right atrial diameters, areas, and volumes compared to controls.
- Atrial emptying fraction and expansion index were reduced in ACS patients.
- Lower peak systolic (S') and early diastolic (E') velocities were observed in atrial walls of ACS patients.
Conclusions:
- ACS significantly impacts biatrial size and function.
- Echocardiographic parameters of atrial dimensions, volumes, and TDI velocities are altered in ACS.
- Comprehensive atrial assessment is crucial in managing ACS patients.
Abstract:
After acute coronary syndromes (ACS), cardiac remodelling affecting not only ventricles but also both atria is an important problem associated with an increased risk for adverse cardiovascular outcomes. However, it is usually underestimated to evaluate atrial size and functions. The aim of the present study is to compare left and right atrial size and functions in ACS patients with healthy controls during transthoracic echocardiography by means of diameter, area and volume measurements, and pulsed-wave tissue Doppler imaging (TDI). 150 ACS patients (128 male, 22 female) and 25 healthy controls (19 male, 6 female) were enrolled into the study. Of the ACS patients, 75 had ST-segment elevation myocardial infarction (STEMI) and 75 had non-STEMI. Biatrial diameters, areas, and volumes were measured from different echocardiographic views. Atrial total emptying fraction and expansion index values were calculated from volume measurements. By the pulsed-wave TDI of the atrial walls; peak systolic (S'), peak early diastolic (E'), and peak late diastolic (A') velocities were measured. Almost all left atrial parameters for diameter, area, and volume measurements were higher in ACS patients. Similarly, they had higher values for the same right atrial parameters. Left and right atrial total emptying fraction and expansion index values were lower in ACS patients than controls. All left and right atrial walls had lower S' and E' velocities in ACS patients. ACS cause important alterations in the biatrial size and functions evaluated by echocardiographic diameter, area and volume measurements, and pulsed-wave TDI.
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