Left atrial volume and function in patients with cardiac syndrome X assessed by real time three-dimensional echocardiography

Echocardiography. 2017 Jun;34(6):862-868. doi: 10.1111/echo.13534. Epub 2017 Apr 4.


Objective: The aim of this study was to evaluate left atrial (LA) volume and function using real time three-dimensional echocardiography (RT3DE) in patients with cardiac syndrome X (CSX).

Methods: Fifty patients with CSX (28 females; mean age 50.9±10.9 years) and 50 age- and gender-matched healthy controls (30 females; mean age 52.3±9.8 years) who had negative treadmill exercise test and normal coronary arteries on invasive coronary angiography were included in the study. Comprehensive two-dimensional (2D), pulsed and tissue Doppler, speckle tracking echocardiography, and RT3DE for the assessment of LA dynamics were performed in all study participants.

Results: Cardiac syndrome X and control groups have similar clinical characteristics regarding age, sex, body mass index, hypertension, diabetes, and smoking habit. 2D echocardiographic parameters were also similar between groups. Pulsed- and tissue Doppler parameters, IVRT, A, and Am values, were higher in CSX group, while Em , E/A, and Em /Am ratios were higher in the control group reflecting mild diastolic dysfunction. Regarding RT3DE parameters, LA maximum volume, minimum volume, volume before atrial contraction, LA maximum volume index, total and active stroke volumes were found to be increased in CSX patients. However, LA total stroke fraction, passive stroke volume, passive stroke fraction, peak systolic, and diastolic longitudinal strains were found to be lower in CSX patients.

Conclusion: The main finding of this study was that CSX patients had altered LA booster pump, reservoir, and conduit functions. This finding may have clinical implications for early detection of abnormal LA dynamics in CSX patients.

Keywords: left atrial volume; myocardial ischemia; three-dimensional transthoracic echocardiography.

MeSH terms

  • Echocardiography, Three-Dimensional / methods*
  • Female
  • Heart Atria / diagnostic imaging
  • Heart Atria / pathology
  • Heart Atria / physiopathology
  • Humans
  • Male
  • Microvascular Angina / diagnostic imaging*
  • Microvascular Angina / pathology
  • Microvascular Angina / physiopathology*
  • Middle Aged
  • Organ Size