Assessment of Left Atrial Systolic Function and Morphology in Patient with Ischemic Heart Disease: Using Multidetector Computed Tomography versus Transthoracic Echocardiography

Abstract

Background: Atherosclerosis is a disease characterized by dysfunction of endothelial lining of vessels associated with buildup of lipids, cholesterol inflammatory cells and cellular debris within intima &sub intimal layers resulting in plaque formation. Aim of the Work: The aim of this study is to assess left atrial function in terms of changes in size, volumes and systolic function parameters in patients with isolated IHD in comparison to normal control subjects as detected by MSCT versus transthoracic echocardiography. Patients and Methods: The study was conducted on 100 patients with known or suspected coronary artery disease referred for 64-MSCT at cardiology department of Ain Shams University f hospital in Cairo. The 100patients were divided in to two groups: 1- Group (A): 60 patients with known ischemic heart disease based on: history, 12- leads electrocardiogram and echocardiography. 2- Group (B): 40 patients with suspected ischemic heart disease. The suspicion was based on history, as they had normal echocardiography, normal exercise stress test and negative dobutamine stress echocardiography. Results: the study revealed positive correlation between LA minimum volume by echocardiography and MSCT. Also, there was a positive correlation between LA maximum volume by echocardiography and MSCT. Conclusion: There was a good correlation between the two different methods for evaluating the LA volumes using MSCT and echocardiography as regard left atrial maximum and minimum volumes. However, the LA diameters by echocardiography were larger in ischemic patient than normal group. Recommendations: Based on this study the following are recommended: Measuring LA volumes and function should become a part of the investigation during the scan and including it in the final report of the MSCT. A study is needed to evaluate the prognostic value of measuring LA volume and systolic function measured by MSCT in patient with ischemic heart disease. Key words: Atherosclerosis, coronary artery disease, MSCT, IHD, endothelial lining of vessels