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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left atrial strain rate: marker of hemodynamically significant coronary artery stenosis?

Egle Rumbinaite1, Dovydas Verikas1,2, Arnas Karuzas1,2

  • 1Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, 50161, Lithuania.

Future Cardiology
|June 1, 2023
PubMed

Insights

Left atrial strain rate during dobutamine stress echocardiography can help identify coronary artery disease. Lower early diastolic strain rate (LAe SR) indicates significant coronary artery stenosis in patients with suspected coronary artery disease (CAD).

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Echocardiography

Background:

  • Coronary artery disease (CAD) diagnosis often relies on invasive procedures.
  • Non-invasive methods for assessing myocardial ischemia are crucial for patient management.
  • Left atrial function is increasingly recognized as an indicator of cardiovascular health.

Purpose of the Study:

  • To evaluate the diagnostic utility of left atrial deformation parameters.
  • To predict significant coronary artery stenosis using dobutamine stress echocardiography (DSE).
  • To assess patients with moderate pretest probability of CAD.

Main Methods:

  • Dobutamine stress echocardiography (DSE) performed on 61 patients.
  • Assessment of left atrial deformation parameters, including early diastolic strain rate (LAe SR).
  • Patients categorized into pathological (CAD present) and non-pathological groups.

Main Results:

  • Significantly lower LAe SR observed in the pathological group at high dobutamine doses.
  • Receiver operating characteristic (ROC) curve analysis identified a prognostic threshold for LAe SR (-2.05).
  • The threshold demonstrated 78% sensitivity and 50% specificity (AUC 0.638, p=0.026).

Conclusions:

  • Left atrial early diastolic strain rate (LAe SR) has predictive value for significant coronary artery stenosis.
  • LAe SR may serve as a valuable non-invasive parameter for assessing myocardial ischemia.
  • This parameter could aid in the diagnostic workup of patients with suspected CAD.

Keywords:
dobutamine stress echocardiographyleft atrial deformationspeckle tracking imagingstable coronary artery disease

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