Left atrial function in patients with coronary artery disease: Role of 2D strain. État d’avancement du travail

Abstract

Left ventricular (LV) dysfunction in patients with coronary artery disease (CAD) is shown by strain and strain rate imaging. However, left atrium (LA) function in such patients has been little studied by this method and impairment of atrial function in CAD due to ischemia has not been clearly evaluated. We aimed to evaluate left atrial function in patients with CAD and to determine whether 2D strain can be helpful to detect CAD in these patients. Seventy patients with CAD, with normal-size LA (LA diameter ≤ 4.0 cm, volume max index < 34 ml/m 2 ) (CAD group), fifty age-and-sex matched healthy subjects as a control group were included. Echocardiography was performed in patients in the two groups to evaluate left ventricular (LV) diastolic and systolic function, LA volume, and LA function. Two-dimensional strain echocardiographic imaging (2DSE) was performed. Both conventional parameters, strain and strain rate parameters, such as LA peak systolic strain and strain rate (LAs S/SR), early diastolic strain rate (LAe SR) and late diastolic strain and strain rate (LAa S/SR), were measured. Clinical and conventional echocardiographic parameters, including Doppler measurements, did not differ significantly between the two groups. LAs S/SR and LAe SR were lower in patients than in healthy subjects ( P < 0.05). No differences were found between the two groups regarding LAa S/SR. A significant correlation was observed between LAs S/SR and LA emptying fraction ( r = 0.63, P < 0.05; r = 0.49, P < 0.05, respectively). LAa S/SR were correlated to LA ejection fraction ( r = 0.71, P < 0.05; r = 0.51, P < 0.05, respectively). LAs SR was most reliable in identifying CAD patients from controls (AUC = 0.74) ( Fig. 1 ). Our results suggest that LAs S/SR may be a usuful parameter to identify patients with CAD.