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

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 (ε(s)) and SR during LV systole (SRs), SR during early LV filling (SRe) and late LV filling (SRa) were measured. Longitudinal strain during atrial contraction (ε(a)) was obtained at the onset of P-wave on electrocardiography, and ε(a)/ε(s) was calculated. RESULTS Longitudinal peak ε(s) and SRs of LA showed decreased trend among CAD patients. The global and lateral LA SRe were prominently lower, while RA ε(a), SRa and ε(a)/ε(s) 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 ε(a)/ε(s) 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; ε(a)/ε(s) 0.44±0.11, 0.44±0.20, 0.57±0.12, P value<0.01). CONCLUSIONS Apparently decreased SRe of LA and increased ε(a), SRa and ε(a)/ε(s) of RA were found in CAD patients with preserved LVEF and E/E' in gray zone. SRa and ε(a)/ε(s) of LA were found to significantly increase in those with LAD stenosis.