Real-time three-dimensional echocardiography of left atrial volume and function in patients with severe multi-vessel coronary artery disease.
OBJECTIVE
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China.
Lingjie
L
Yang
Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China.
Li
L
Ma
Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China. liyanhong1112@sina.com.
Yanhong
Y
Li
Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China. mym1234@126.com.
Yuming
Y
Mu
Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China.
Liyun
L
Liu
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016279:Atrial Function, Left; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012720:Severity of Illness Index; D013318:Stroke Volume
Echocardiography; Left atrial function; Multi-vessel coronary artery disease