title: Correlation of echocardiographic left atrial abnormality with myocardial ischemia during myocardial perfusion assessment in the presence of known left ventricular hypertrophy.
abstract: Left atrial (LA) abnormality, an easily quantifiable parameter of left ventricular (LV) diastolic dysfunction, has been associated with cardiovascular risk similar to that of LV hypertrophy. The correlation between LV hypertrophy and LA abnormality among patients undergoing myocardial perfusion (MP) study has not been described. We prospectively studied 78 consecutive patients with LV hypertrophy who underwent MP study after screening for electrocardiographic and echocardiographic LA abnormality over a 6-month period. Of those, 48 had a positive MP imaging result, and 30 did not. LA size (p = 0.002) and P-wave duration (p = 0.017) were significantly increased in the former. The differential change in LA size (no defect = 35 ± 4, mild = 36 ± 5, moderate = 38 ± 5, severe = 44 ± 5 mm; p <0.0001) and P-wave duration (no defect = 107 ± 14, mild = 110 ± 17, moderate = 113 ± 15, severe = 127 ± 22 ms; p = 0.003) was greatest when the MP study defect exceeded moderate severity. In conclusion, the presence of LA abnormality could assist during MP study interpretation among patients with LV hypertrophy when such markers appear to be correlated with the severity of the MP study defect.
authors.affiliation: Department of Medicine, Clara Maass Medical Center, Belleville, NJ, USA.
authors.forename: Amar
authors.initials: A
authors.lastname: Nawathe
authors.forename: Vignendra
authors.initials: V
authors.lastname: Ariyarajah
authors.forename: Sirin
authors.initials: S
authors.lastname: Apiyasawat
authors.forename: Ivan
authors.initials: I
authors.lastname: Barac
authors.forename: David H
authors.initials: DH
authors.lastname: Spodick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D003971:Diastole / Q000502:physiology*; D004176:Dipyridamole; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted; D013223:Statistics as Topic; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
chemical_list: D014665:Vasodilator Agents; D004176:Dipyridamole