Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Determinants of the Volumetric Markers of Left Atrial Contraction Function in Coronary Artery Disease: A Cross-sectional Study

  • Taimoor Etemad (Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences) ;
  • Ali Hosseinsabet (Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences) ;
  • Negar Omidi (Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences) ;
  • Reza Mohseni-Badalabadi (Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences)
  • Received : 2021.02.13
  • Accepted : 2021.05.23
  • Published : 2022.01.27
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Abstract

BACKGROUND: A body of research advocates the prognostic role and usefulness of the volumetric markers of left atrial (LA) phasic functions in the diagnosis of LA dysfunction. We aimed to determine the independent determinants of the volumetric markers of LA contraction function in candidates for coronary artery bypass graft (CABG) surgery. METHODS: This cross-sectional study enrolled 516 candidates for CABG. The biplane maximal, minimal, and pre-P volumes of the LA were measured with two-dimensional echocardiography, and LA active emptying fraction was calculated. The standardized correlation coefficient for the correlation between each factor and LA active emptying fraction was calculated by using univariate and backward multivariable regression analyses. RESULTS: The multivariable regression analysis demonstrated that the heart rate (β = 0.15; p = 0.001), S (β = 0.09; p = 0.036), E/e' ratio (β = -0.11; p = 0.014), left ventricle (LV) ejection fraction (β = 0.15; p = 0.001), and LA enlargement (β = -0.19; p < 0.001) were the independent determinants of LA active emptying fraction. CONCLUSIONS: The independent determinants of LA contraction function were the heart rate, S, LV ejection fraction, LA enlargement, and E/e' ratio in candidates for CABG surgery.

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References

  1. Kebed KY, Addetia K, Lang RM. Importance of the left atrium: more than a bystander? Heart Fail Clin 2019;15:191-204. https://doi.org/10.1016/j.hfc.2018.12.001
  2. Todaro MC, Choudhuri I, Belohlavek M, et al. New echocardiographic techniques for evaluation of left atrial mechanics. Eur Heart J Cardiovasc Imaging 2012;13:973-84. https://doi.org/10.1093/ehjci/jes174
  3. Thomas L, Marwick TH, Popescu BA, Donal E, Badano LP. Left atrial structure and function, and left ventricular diastolic dysfunction: JACC state-of-the-art review. J Am Coll Cardiol 2019;73:1961-77. https://doi.org/10.1016/j.jacc.2019.01.059
  4. Hoit BD. Assessment of left atrial function by echocardiography: novel insights. Curr Cardiol Rep 2018;20:96.
  5. Leischik R, Littwitz H, Dworrak B, et al. Echocardiographic evaluation of left atrial mechanics: function, history, novel techniques, advantages, and pitfalls. BioMed Res Int 2015;2015:765921.
  6. Yang L, Ma L, Li Y, Mu Y, Liu L. Real-time three-dimensional echocardiography of left atrial volume and function in patients with severe multi-vessel coronary artery disease. J Med Ultrason (2001) 2017;44:71-8. https://doi.org/10.1007/s10396-016-0754-5
  7. Worley E, Rana B, Williams L, Robinson S. Left ventricular diastolic dysfunction: identifying presence by left atrial function. Echo Res Pract 2018;5:97-104. https://doi.org/10.1530/ERP-18-0013
  8. Bytyci I, Bajraktari G. Left atrial changes in early stages of heart failure with preserved ejection fraction. Echocardiography 2016;33:1479-87. https://doi.org/10.1111/echo.13306
  9. Gulmez O, Parildar H, Cigerli O, Demirag N. Assessment of left atrial function in patients with type 2 diabetes mellitus with a disease duration of six months. Cardiovasc J Afr 2018;29:82-7. https://doi.org/10.5830/CVJA-2017-048
  10. Antit S, Zakhama L, Amri A, Boussabeh E, Thameur M, Ben Youssef S. Assessment of left atrial mechanical function by two-dimensional echocardiography in hypertensive patients. Tunis Med 2019;97:882-90.
  11. Tugcu A, Russo C, Jin Z, et al. Association of body size metrics with left atrial phasic volumes and reservoir function in the elderly. Eur Heart J Cardiovasc Imaging 2018;19:1157-64. https://doi.org/10.1093/ehjci/jex236
  12. Modin D, Olsen FJ, Pedersen S, Jensen JS, Biering-Sorensen T. Measures of left atrial function predict incident atrial fibrillation in STEMI patients treated with primary percutaneous coronary intervention. Int J Cardiol 2018;263:1-6. https://doi.org/10.1016/j.ijcard.2018.03.013
  13. Modin D, Pedersen S, Fritz-Hansen T, Gislason G, Biering-Sorensen T. Left Atrial function determined by echocardiography predicts incident heart failure in patients with STEMI treated by primary percutaneous coronary intervention. J Card Fail 2020;26:35-42. https://doi.org/10.1016/j.cardfail.2019.08.014
  14. Wang WH, Hsiao SH, Lin KL, Wu CJ, Kang PL, Chiou KR. Left atrial expansion index for predicting atrial fibrillation and in-hospital mortality after coronary artery bypass graft surgery. Ann Thorac Surg 2012;93:796-803. https://doi.org/10.1016/j.athoracsur.2011.11.007
  15. Hidayet S, Yagmur J, Bayramoglu A, Tasolar MH, Kurtoglu E, Ozyalin F. Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT-pro ANP levels after coronary artery bypass surgery: a three-dimensional echocardiography study. Echocardiography 2018;35:661-6. https://doi.org/10.1111/echo.13833
  16. Ali M, Girgis S, Hassan A, Rudick S, Becker RC. Inflammation and coronary artery disease: from pathophysiology to Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). Coron Artery Dis 2018;29:429-37. https://doi.org/10.1097/MCA.0000000000000625
  17. Sani CM, Pogue EP, Hrabia JB, et al. Association between low-grade chronic inflammation and depressed left atrial compliance in heart failure with preserved ejection fraction: a retrospective analysis. Folia Med Cracov 2018;58:45-55.
  18. 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. https://doi.org/10.1111/j.1540-8175.2011.01513.x
  19. Lin QW, Wang WG, Wu WC, Wang H. Left atrial minimum volume by real-time three-dimensional echocardiography as an indicator of diastolic dysfunction. Chin Med J (Engl) 2013;126:4227-31. https://doi.org/10.3760/cma.j.issn.0366-6999.20130465
  20. El Missiri A, Awadalla H. Left atrial contractility in ischemic heart disease patients with left ventricular systolic dysfunction. J Cardiovasc Echogr 2016;26:11-5. https://doi.org/10.4103/2211-4122.178469
  21. Hosseinsabet A, Mohseni-Badalabadi R, Jalali A. Two-dimensional speckle-tracking echocardiography evaluation of left atrial function according to glycemic state in patients with coronary artery disease. Cardiovasc Endocrinol 2017;6:101-8. https://doi.org/10.1097/XCE.0000000000000127
  22. Tadic M, Ilic S, Cuspidi C, et al. Left and right atrial phasic function and deformation in untreated patients with prediabetes and type 2 diabetes mellitus. Int J Cardiovasc Imaging 2015;31:65-76. https://doi.org/10.1007/s10554-014-0536-3
  23. Etemad T, Hosseinsabet A. Determinants of left intra-atrial electromechanical delay as evaluated by tissue Doppler imaging in candidates for coronary artery bypass graft surgery. Echocardiography 2020;37:260-9. https://doi.org/10.1111/echo.14599
  24. Hoit BD. Left atrial remodeling: more than just left atrial enlargement. Circ Cardiovasc Imaging 2017;10:e006036.
  25. Pagel PS, Kehl F, Gare M, Hettrick DA, Kersten JR, Warltier DC. Mechanical function of the left atrium: new insights based on analysis of pressure-volume relations and Doppler echocardiography. Anesthesiology 2003;98:975-94. https://doi.org/10.1097/00000542-200304000-00027
  26. Inoue K, Khan FH, Remme EW, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging 2021;35:1618-25.
  27. Abdelghani Abdelzaher M, Atteia WM. Left atrial geometry and pump function in ischemic cardiomyopathy. Int J Cardiol Heart Vasc 2014;5:45-50. https://doi.org/10.1016/j.ijcha.2014.10.009
  28. Cao S, Zhou Q, Chen JL, Hu B, Guo RQ. The differences in left atrial function between ischemic and idiopathic dilated cardiomyopathy patients: a two-dimensional speckle tracking imaging study. J Clin Ultrasound 2016;44:437-45. https://doi.org/10.1002/jcu.22352
  29. Fan JL, Su B, Zhao X, et al. Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with normal left ventricular ejection fraction. Int J Cardiovasc Imaging 2020;36:1659-66. https://doi.org/10.1007/s10554-020-01869-7
  30. Murai D, Yamada S, Hayashi T, et al. Relationships of left ventricular strain and strain rate to wall stress and their afterload dependency. Heart Vessels 2017;32:574-83. https://doi.org/10.1007/s00380-016-0900-4
  31. Piros GA, Domsik P, Kalapos A, et al. Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiography (from the MAGYAR-Healthy Study). Rev Port Cardiol 2016;35:83-91. https://doi.org/10.1016/j.repc.2015.09.017
  32. Voigt JU, Cvijic M. 2- and 3-dimensional myocardial strain in cardiac health and disease. JACC Cardiovasc Imaging 2019;12:1849-63. https://doi.org/10.1016/j.jcmg.2019.01.044
  33. Zhang Q, Kum LC, Lee PW, et al. Effect of age and heart rate on atrial mechanical function assessed by Doppler tissue imaging in healthy individuals. J Am Soc Echocardiogr 2006;19:422-8. https://doi.org/10.1016/j.echo.2005.11.015
  34. Borde D, Joshi S, Jasapara A, Joshi P, Asegaonkar B, Apsingekar P. Left atrial strain as a single parameter to predict left ventricular diastolic dysfunction and elevated left ventricular filling pressure in patients undergoing off-pump coronary artery bypass grafting. J Cardiothorac Vasc Anesth 2021;35:1618-25. https://doi.org/10.1053/j.jvca.2020.11.066
  35. Hadadi M, Mohseni-Badalabadi R, Hosseinsabet A. Assessment of the ability of the CHA2DS2-VASc scoring system to grade left atrial function by 2D speckle-tracking echocardiography. BMC Cardiovasc Disord 2021;21:94.
  36. Gabrielli L, Corbalan R, Cordova S, et al. Left atrial dysfunction is a predictor of postcoronary artery bypass atrial fibrillation: association of left atrial strain and strain rate assessed by speckle tracking. Echocardiography 2011;28:1104-8. https://doi.org/10.1111/j.1540-8175.2011.01518.x
  37. Leung JM, Bellows WH, Schiller NB. Impairment of left atrial function predicts post-operative atrial fibrillation after coronary artery bypass graft surgery. Eur Heart J 2004;25:1836-44. https://doi.org/10.1016/j.ehj.2004.07.014
  38. Said KM, Nassar AI, Fouad A, Ramzy AA, Abd Allah MF. Left atrial deformation analysis as a predictor of severity of coronary artery disease. Egypt Heart J 2018;70:353-9. https://doi.org/10.1016/j.ehj.2018.09.004
  39. van den Berg NW, Chan Pin Yin DR, Berger WR, et al. Comparison of non-triggered magnetic resonance imaging and echocardiography for the assessment of left atrial volume and morphology. Cardiovasc Ultrasound 2018;16:17.