Abstract
BackgroundImpaired 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.MethodsEchocardiographic 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 (εs) and SR during LV systole (SRs), SR during early LV filling (SRe) and late LV filling (SRa) were measured. Longitudinal strain during atrial contraction (εa) was obtained at the onset of P-wave on electrocardiography, and εa/εs was calculated.ResultsLongitudinal peak εs and SRs of LA showed decreased trend among CAD patients. The global and lateral LA SRe were prominently lower, while RA εa, SRa and εa/εs 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 εa/εs 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; εa/εs 0.44±0.11, 0.44±0.20, 0.57±0.12, P value<0.01).ConclusionsApparently decreased SRe of LA and increased εa, SRa and εa/εs of RA were found in CAD patients with preserved LVEF and E/E' in gray zone. SRa and εa/εs of LA were found to significantly increase in those with LAD stenosis.
Highlights
Coronary artery disease (CAD) is a major public health problem with high risk of developing heart failure
The aim of this study is to evaluate the function of both atrial myocardium in coronary artery disease (CAD) patient using vector velocity imaging (VVI), and to test our novel hypothesis that atrial impairment might be associated with the severity of coronary stenosis and the distribution pattern of obstructive coronary artery
There was no difference in age, gender distribution, blood pressure, blood glucose/NT-proBNP levels, or kidney function among the 3 groups
Summary
Coronary artery disease (CAD) is a major public health problem with high risk of developing heart failure. Accumulative evidence has shown that strain (e) and strain rate (SR) are powerful echocardiographic parameters to directly reflect global and regional systolic and diastolic myocardial deformation [4,5,6,7,8], and to sensitively detect dysfunction from myocardial ischemia in CAD patients [9,10,11,12]. 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
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