Left Atrial and Right Atrial Deformation in Patients with Coronary Artery Disease: A Velocity Vector Imaging-Based Study

Abstract

Background: 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. Methods: Echocardiographic 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. Results: Longitudinal 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). Conclusions: Apparently 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. © 2012 Yan et al.