Is It Possible to Predict False-Positive Exercise Stress Echocardiography Results by Measuring the Left Atrial...

Area of Science:

• Cardiology
• Diagnostic Imaging
• Echocardiography

Background:

• Left atrial (LA) size is a known prognostic factor in coronary artery disease (CAD).
• Previous studies have not evaluated LA antero-posterior (A-P) diameter for screening low-probability CAD patients.
• This study investigates LA A-P diameter adjusted for thoracic dimensions to predict false-positive (FP) exercise stress echocardiography (ESE) results.

Purpose of the Study:

• To assess the influence of LA A-P diameter adjusted for A-P thoracic diameter on FP-ESE occurrence.
• To determine if this ratio can serve as a screening tool for identifying individuals with a low probability of obstructive CAD.

Main Methods:

• Retrospective analysis of 160 patients with suspected CAD and positive ESE undergoing coronary angiography.
• Assessment of LA A-P diameter/A-P thoracic diameter ratio and resting transthoracic echocardiography.
• Primary endpoint: FP-ESE, defined as positive ESE without obstructive CAD (≥70% stenosis).

Main Results:

• 19.4% of patients (31/160) had FP-ESE.
• LA A-P diameter/A-P thoracic diameter ratio showed a strong inverse correlation with FP-ESE (OR 0.42).
• A ratio ≤0.25 demonstrated 100% sensitivity and 85% specificity for predicting FP-ESE (AUC=0.94).

Conclusions:

• Echocardiographic LA A-P diameter adjusted for thoracic diameter is a valuable tool.
• This measurement can help identify patients at lower risk of obstructive CAD among those with suspected CAD.
• It aids in predicting false-positive ESE results, potentially reducing unnecessary invasive procedures.