Real-time three-dimensional echocardiography of left atrial volume and function in patients with severe multi-vessel coronary artery disease
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To evaluate the changes in left atrial (LA) volume and function in patients with severe multi-vessel coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT-3DE).
One hundred and eight subjects were stratified based on coronary angiography (CAG) imaging, comprising 48 patients with severe multi-vessel CAD, 31 patients with severe single-vessel CAD, and 29 controls. RT-3DE was performed in all groups. LA volume parameters were measured. LA ejection fractions (EF) and LA function index (LAFI) were also calculated.
There were no significant differences between the single-vessel CAD group and the control group, while LA passive emptying fraction (LAVpEF) was significantly reduced in the single-vessel CAD group. In the multi-vessel CAD group, LAVpEF and LAFI were lower, while LA presystolic volume (LAVpre) was prominently higher as compared with the other groups, and LA active emptying volume (LAVa) was higher than that in the control group (p < 0.05). Receiver-operating characteristic (ROC) analysis showed that the area under the curve (AUC) of LAVpEF was the largest parameter; the optimal cut-off value, AUC, sensitivity, and specificity were 0.50, 0.864, 93.7, and 72.4 %, respectively.
Specifically, conduit function reflects the early changes in LA function, and CAD damage is aggravated with increasing coronary lesions, whereas the booster pump function of severe multi-vessel CAD can increase in compensation. We speculate that LAVpEF may be the most ideal threshold for detecting and differentiating severe CAD patients from controls.
KeywordsEchocardiography Multi-vessel coronary artery disease Left atrial function
This study was supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region (Grant No. 2014211C054).
Compliance with ethical standards
Conflict of interest
Lingjie Yang, Li Ma, Yanhong Li, Yuming Mu, and Liyun Liu declare that they have no conflict of interest.
The study was approved by the Medical Ethics Committee of the Hospital, and all subjects provided written informed consent.