Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Purpose

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Teo SG, Yang H, Chai P, et al. Impact of left ventricular diastolic dysfunction on left atrial volume and function: a volumetric analysis. Eur J Echocardiogr. 2010;11:38–43.

    Article  PubMed  Google Scholar 

  2. Tan YT, Wenzelburger F, Lee E, et al. Reduced left atrial function on exercise in patients with heart failure and normal ejection fraction. Heart. 2010;96:1017–23.

    Article  CAS  PubMed  Google Scholar 

  3. Stewart JT, Grbic M, Sigwart U. Left atrial and left ventricular diastolic function during acute myocardial ischaemia. Br Heart J. 1992;68:377–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Mor-Avi V, Yodwut C, Jenkins C, et al. Real-time 3D echocardiographic quantification of left atrial volume multicenter study for validation with magnetic resonance imaging. J Am Coll Cardiol Img. 2012;5:769–77.

    Article  Google Scholar 

  5. Yodwut C, Weinert L, Klas B, et al. Effects of frame rate on three-dimensional speckle-tracking-based measurements of myocardial deformation. J Am Soc Echocardiogr. 2012;25:978–85.

    Article  PubMed  Google Scholar 

  6. Aune E, Baekkevar M, Roislien J, et al. Normal reference ranges for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography. Eur J Echocardiogr. 2009;10:738–44.

    Article  PubMed  Google Scholar 

  7. Zhong L, Tan RS, Ghista D. Proper use of left atrial ejection force as a measure of left atrial mechanical function. Echocardiography. 2012;29:878–84.

    Article  PubMed  Google Scholar 

  8. Cameli M, Lisi M, Righini FM, et al. Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovasc Ultrasound. 2012;10:4.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Toh N, Kanzaki H, Nakatani S, et al. Left atrial volume combined with atrial pump function identifies hypertensive patients with a history of paroxysmal atrial fibrillation. Hypertension. 2010;55:1150–6.

    Article  CAS  PubMed  Google Scholar 

  10. Farzaneh-Far A, Ariyarajah V, Shenoy C, et al. Left atrial passive emptying function during dobutamine stress MR imaging is a predictor of cardiac events in patients with suspected myocardial ischemia. JACC Cardiovasc Imaging. 2011;4:378–88.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Liu YY, Xie MX, Xu JF, et al. Evaluation of left atrial function in patients with coronary artery disease by two-dimensional strain and strain rate imaging. Echocardiography. 2011;28:1095–103.

    Article  CAS  PubMed  Google Scholar 

  12. Yan P, Sun B, Shi H, et al. Left atrial and right atrial deformation in patients with coronary artery disease: a velocity vector imaging-based study. PLoS One. 2012;7:e51204.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Kühl JT, Kofoed KF, Møller JE, et al. Assessment of left atrial volume and mechanical function in ischemic heart disease: a multi slice computed tomography study. Int J Cardiol. 2010;145:197–202.

    Article  PubMed  Google Scholar 

  14. Tsang TS, Barnes ME, Gersh BJ, et al. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002;90:1284–9.

    Article  PubMed  Google Scholar 

  15. Facchini E, Degiovanni A, Marino PN. Left atrium function in patients with coronary artery disease. Curr Opin Cardiol. 2014;29:423–9.

    Article  PubMed  Google Scholar 

  16. Kuzeytemiz M, Tenekecioglu E, Yilmaz M, et al. Assessment of left atrial functions in cardiac syndrome X. Eur Rev Med Pharmacol Sci. 2015;19:3023–9.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region (Grant No. 2014211C054).

Author information

Author notes

    Authors and Affiliations

    1. Department of Echocardiography, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yu Shan South Road, Urumqi, 830011, China

      Lingjie Yang, Li Ma, Yanhong Li, Yuming Mu & Liyun Liu

    Authors
    1. Lingjie Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Li Ma
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Yanhong Li
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Yuming Mu
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Liyun Liu
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding authors

    Correspondence to Yanhong Li or Yuming Mu.

    Ethics declarations

    Conflict of interest

    Lingjie Yang, Li Ma, Yanhong Li, Yuming Mu, and Liyun Liu declare that they have no conflict of interest.

    Ethical statements

    The study was approved by the Medical Ethics Committee of the Hospital, and all subjects provided written informed consent.

    Additional information

    L. Yang and L. Ma contributed equally to the work.

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Yang, L., Ma, L., Li, Y. et al. Real-time three-dimensional echocardiography of left atrial volume and function in patients with severe multi-vessel coronary artery disease. J Med Ultrasonics 44, 71–78 (2017). https://doi.org/10.1007/s10396-016-0754-5

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10396-016-0754-5

    Keywords

    Search

    Navigation