Left atrial deformation analysis as a predictor of severity of coronary artery disease

Abstract

Background: Two-dimensional (2D) speckle-tracking strain imaging is a novel method for assessment of regional myocardial deformation that uses tracking of acoustic speckles or kernels rather than Doppler myocardial velocities. It has been suggested that Left atrial (LA) strain as measured by 2D speckle tracking can be used to evaluate dynamic LA function. Objective: To study the relation between left atrial deformation and the severity of coronary artery stenosis in patients with stable coronary artery disease (CAD). Study design: 30 patients with stable coronary artery disease (SCAD) with coronary artery stenosis (>50%) who were admitted for elective coronary angiography at Ain Shams University hospitals and AlAzhar University hospitals were included in the study. Measurements of conventional echocardiographic parameters as well as LA strain and strain rate parameters were obtained, Syntax (SX) score was calculated for all patients. Results: Patients were categorized into 3 groups: low Syntax score of <23 (Group I), moderate syntax score 23–32 (Group II) and high syntax score of ≥33 (Group III). Peak atrial longitudinal strain (PALS) (Group I: 29.80 ± 4.48, Group II: 22.44 ± 1.42, Group III: 19.53 ± 4.46; p < 0.001) and Peak atrial contraction strain (PACS) (Group I: 13.43 ± 4.05, Group II: 10.84 ± 2.47, Group III: 7.19 ± 0.71; p < 0.022) were significantly lower in high syntax group. Significant negative correlation was found between SX score level and LA strain parameters (PALS and PACS) (r = 0.861; p < 0.001). Conclusion: Left atrial deformation analysis by 2D Speckle tracking Doppler Echocardiography can predict the severity of coronary affection in patients with stable CAD. Keywords: Left atrium, Deformation, Strain, Speckle tracking