Value of 2D speckle tracking technique combined with real-time 3-dimensional echocardiography in the evaluation of the right atrial function in patients with 3-branch coronary artery disease without myocardial infarction

Abstract

To evaluate the right atrial function in patients with 3-branch coronary artery disease (TBCAD) without myocardial infarction by 2D speckle tracking echocardiography (2D-STE) combined with real-time 3-dimensional echocardiography (RT-3DE). Fifty-six patients admitted to our hospital without myocardial infarction with TBCAD were selected. We divided them into 2 groups according to the coronary angiography results: 28 patients in group B (the rate of stenosis is 50% ~< 75%); 28 patients in group C (the rate of stenosis is ≥75%); in addition, 30 healthy volunteers were screened as group A. All subjects underwent RT-3DE to obtain the right atrial volume (RAVmax, RAVmin, and RAVp), and then we calculated the right atrial passive and active ejection fraction (RAPEF, RAAEF), and maximum volume index (RAVImax). In addition, to measure the strain rates (RASRs, RASRe, RASRa) of the right atrium during systole, early diastole, and late diastole, 2D-STE was applied. Correlations between the 2D-STE parameters and the results of N-terminal pro-brain natriuretic peptide (NT-proBNP) and Gensini scores were analyzed by Pearson linear analysis. Compared with group A, RAPEF and RASRe were reduced, while RAAEF and RASRa were elevated in group B (P < .05). RAPEF, RASRs, RASRe, and RASRa were decreased compared with groups A and B, while RAVmax, RAVmin, RAVp, RAVImax, and RAAEF were increased in group C (P < .05). There was a significant correlation between 2D-STE parameters and the results of NT-proBNP and Gensini scores (P < .05). The storage, conduit, and pump functions of the right atrium are reduced in patients with 3-branch coronary artery disease without myocardial infarction; 2D-STE combined with RT-3DE is valuable in the evaluation of the right atrium in patients with coronary artery disease.

Figure 1.

Global peak longitudinal right atrial strain rates curve of 3 groups were obtained during systole, early diastole, and late diastole (RASRs, RASRe, and RASRa) and obtained by 2D-STE from the apical 4-chamber view. (A) Group A (the control group); (B) group B (the rate of stenosis is 50% ~<75%); (C) group C (the rate of stenosis is ≥75%). 2D-STE = 2D speckle tracking echocardiography.

Figure 2.

ROC curve. The area under the curve for 2D-STE, RT-3DE and the combination of both were 0.9048, 0.8917, and 0.9564. 2D-STE = 2D speckle tracking echocardiography.

Figure 3.

Bland–Altman plot of 2D-STE parameters. (A) Variability of interobserver. (B) Variability of intraobserver. 2D-STE = 2D speckle tracking echocardiography.