Real-time Three Dimensional Echocardiography (RT-3DE) Of Left Atrial Volume And Function In Patients With Severe Multi-vessel Coronary Artery Disease

Objective: To evaluate the changes of 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: 108 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 single-vessel CAD group and control groups,while LA passive emptying fraction(LAVp EF)was significantly reduced in the single-vessel CAD group.In multi-vessel CAD group,LAVpEF and LAFI were lower,while LA presystolic of volume(LAVpre)was higher prominently than other groups,and LA active emptying volume(LAVa)was higher than 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%,72.4%,respectively.Conclusion: Specifically,conduit function reflects early changes of 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 in detecting and differentiating severe CAD patients from controls.