Evaluation of Left Atrial Function in Patients with Coronary Artery Disease by Two‐Dimensional Strain and Strain Rate Imaging

Lin, Yingying; Xie, Mingxing; Xu, Jinfeng; Wang, Xinfang; Lv, Qing; Lu, Xiao-fang; Wang, Jing; He, Lin; Fang, Lingyun; Zhang, Jing

doi:10.1111/j.1540-8175.2011.01513.x

Cited by 27 publications

(41 citation statements)

References 27 publications

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“…We used conventional echocardiography and STE. STE is an imaging technique, in which ultrasound speckles within the image are tracked, and strain is derived from the displacement of speckles relative to each other 31. This new modality enables accurate and reliable measurements of both global and regional myocardial strain and strain rates without the confounding effects of angle dependency (Fig.…”

Section: Discussionmentioning

confidence: 99%

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Çetin

Gökhan

Keskin

et al. 2014

CVJA

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SummaryBackgroundRheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study, we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further, we tried to demonstrate the effects of infliximab, an anti-TNFalpha agent, on echocardiographical LA abnormality in RA patients with preserved left ventricular (LV) ejection fraction.MethodsWe compared 38 female RA patients without clinical evidence of heart disease and 30 female controls without RA and clinical evidence of heart disease. Further, we compared RA patients receiving infliximab and increasing doses of prednisolone over a three-month period. At baseline and post treatment, this study assessed (1) LA and LV parameters using conventional and speckle tracking echocardiography (STE), and (2) electrocardiographic P-wave changes.ResultsThe values of C-reactive protein (CRP), isovolumic relaxation time (IVRT), A wave, and deceleration time (DT) were significantly higher in RA patients compared to the control group (p < 0.05), whereas E/E′ and E/A values were found to be lower (p < 0.05) in RA patients. E/E′ values were lower in prednisolone- compared to infliximab-treated patients (p < 0.05). After three months of infliximab and prednisolone treatment, CRP and disease activity score (DAS 28) values decreased in both groups (p < 0.05), and Duke activity status index (DASI) increased (p < 0.05). Maximal left atrial volume index (LAVImax), pre-contraction left atrial volume index (LAVIpreA) and maximum P wave (Pmax) of the RA patients were higher compared to the control group (p < 0.05), whereas LA global strain was found to be lower (p < 0.05). There was no difference in Pmax values between groups before and after the treatment period. E/E′, LAVImax and LAVIpreA values of infliximab-treated patients decreased and LA global strain increased after three months of therapy compared to baseline (p < 0.05). At baseline in both treatment groups, E/E′ and LA global late diastolic strain rate were lower in prednisolone-compared to infliximab-treated patients (p < 0.05).ConclusionThere was echocardiographic LA abnormality in these RA patients. In this patient group there was also a meaningful increase in maximum P wave assessed by electrocardiography. Infliximab therapy for a period of three months improved LA abnormality.

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Section: Discussionmentioning

confidence: 99%

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Çetin

Gökhan

Keskin

et al. 2014

CVJA

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“…Atrial contractile dysfunction appears early in ischemic heart disease (IHD), irrespective of previous myocardial infarction, co-existing systolic dysfunction, or severity of diastolic dysfunction [26], [9], [8]. Yu et al found that the peak regional atrial contraction velocities at atrial systole (V Aa ) measured at mid-level of the inter-atrial septum and the lateral LA in the apical four chamber view were drastically reduced in patients with IHD when compared with normal controls.…”

Section: Discussionmentioning

confidence: 99%

“…LA contractile dysfunction was, however, demonstrable in patients with coronary artery disease (CAD) even when the LV systolic function was preserved and LA was not enlarged [8].…”

Section: Introductionmentioning

confidence: 99%

Left atrial geometry and pump function in ischemic cardiomyopathy

Abdelghani

Atteia

2014

IJC Heart & Vasculature

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BackgroundMany of the factors that are known to alter left atrial (LA) contractility are present in patients with ischemic cardiomyopathy (ICM). Nevertheless, preservation of LA contractile function in this group of patients was reported in previous studies. The aim of this study was to assess the changes in LA size, geometry and contractile function in ICM.Methods and results60 subjects (age: 49 ± 12 years, 53% males) in sinus rhythm undergoing coronary angiography (CA), were enrolled in this study; 15 subjects as a control group, 30 patients with reduced ejection fraction (EF) and significant coronary artery disease; as the ICM group, and 15 with reduced EF and normal CA; as the dilated cardiomyopathy (DCM) group.LA dimensions, volume, active emptying fraction (ACTEF) and eccentricity index (LAEi) as well as late diastolic velocities of the mitral annulus (a′) and LA free wall (A3) were measured.Compared with the control group, ICM patients had larger LA volume and reduced ACTEF, a′ and A3, with no significant difference between patients with ICM and DCM in any of these parameters. LA eccentricity was, non-significantly, higher in both cardiomyopathy groups than in the control group.ConclusionsPatients with ICM have increased LA volume and reduced LA contractile function in comparison with normal controls. LA enlargement, LA contractile dysfunction and LA geometric changes in ICM are similar to that occurring in DCM. LA size, contractile function and eccentricity may not be reliable in differentiating ischemic from idiopathic dilated cardiomyopathy.

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“…Recent studies have shown that LA myocardial deformation parameters might be reduced before the atrial volume was changed [24], [25]. Furthermore, it is recommended to use several, rather than single doppler echocardiographic technique for the accurate assessment of cardiac diastolic function [26].…”

Section: Discussionmentioning

confidence: 99%

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

Yan

Sun

et al. 2012

PLoS ONE

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BackgroundImpaired 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.MethodsEchocardiographic 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.ResultsLongitudinal 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).ConclusionsApparently 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.

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Evaluation of Left Atrial Function in Patients with Coronary Artery Disease by Two‐Dimensional Strain and Strain Rate Imaging

Abstract: LA diastolic dysfunction occurs prior to LA systolic dysfunction in CAD patients, and LAs SR is the most accurate index in identifying patients with CAD.

Cited by 27 publications

References 27 publications

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Left atrial geometry and pump function in ischemic cardiomyopathy

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

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