Io) was calculated. In addition, the septal mitral annulus early (E’) velocity was measured by tissue doppler imaging, and the E/E’ ratio was calculated using a cutoff value .15 to represent elevated LV filling pressure [20]. All echocardiographic measurements used in the analysis were averaged from 3 heart beats [5].Statistical AnalysisStatistical analysis was performed using SPSS 15.0 statistical software (SPSS Inc., Chicago, Ill., USA). Continuous data were expressed as means 6 SD, and categories data as percentages. Continuous variables were compared using Student’s t-test, or ANOVA when appropriate. Furthermore, Pearson’s and Spearman’s (for nonnormally distributed data) coefficients of correlation were used where appropriate. All of the reported P values were two-sided with statistical significance evaluated at 0.05.Results Clinical CharacteristicsThe clinical data of the 85 participants are presented in Table 1. There was no difference in age, gender distribution, blood pressure, blood glucose/NT-proBNP levels, or kidney function among the 3 groups. None was found to have plasma NT-proBNP .200 pg/ml. Blood lipid Licochalcone-A site levels between groups were also similar, except that triglycerides in patients with severe CAD were higher. The proportions of hypertensive subjects were 15 in mild CAD group, 22 in severe CAD group, and 20 in control group (P value, 0.66). There was no difference in history of medical therapy between the 3 groups. Of the 60 CAD patients, 17 had exclusively left anterior descending coronary artery (LAD) stenosis, and 10 had exclusively left circumflex coronary artery (LCX) or right coronary artery (RCA) stenosis. 33 had multiple-vessel disease. Of all the patients, 33 were successfully treated by percutaneous coronary intervention with stent 520-26-3 implant, while 7 patients needed subsequent coronary arterial bypass grafting surgery.VVI AnalysisFor the assessment of longitudinal atrial deformation, twodimensional grey-scale image of apical 4-chamber view was obtained under VVI mode with highest possible frame rate and a stable electrocardiogram recording. Special attention was paid to avoid foreshortening the atrium and to gain a reliable delineation of the atrial endocardial border. Cine loops with 2? consecutive heart cycles during breath hold were acquired and saved digitally. Strain analysis of LA and RA was performed offline with Siemens syngo US workplace (version 2, Siemens Medical Solutions USA). After manually defining the endocardial borderEchocardiographic FeaturesConventional transthoracic echocardiographic parameters of the study population are presented in Table 2. All the subjects had normal LV diastolic and systolic dimensions. 2 patients with severe CAD were found with mild decreased LV systolic function (LVEF 45?0 ). However, there was no significant difference in LVEF or LVFS between 3 groups. The LA dimensions in control, mild CAD and severe CAD groups were 36.3664.07 mm,Atrial Deformation and Coronary Artery DiseaseFigure 1. Left atrial longitudinal strain/strain rate curves obtained from an apical four-chamber view. es: peak atrial longitudinal strain during ventricular systole, ea: atrial strain at the onset of P-wave on electrocardiography, SRs: peak left atrial strain during LV systole, SRe: peak left atrial strain during early LV diastole, SRa: peak left atrial strain during late LV diastole. doi:10.1371/journal.pone.0051204.gTable 1. Baseline clinical data.Variablecontrol group (n = 25)mild CAD grou.Io) was calculated. In addition, the septal mitral annulus early (E’) velocity was measured by tissue doppler imaging, and the E/E’ ratio was calculated using a cutoff value .15 to represent elevated LV filling pressure [20]. All echocardiographic measurements used in the analysis were averaged from 3 heart beats [5].Statistical AnalysisStatistical analysis was performed using SPSS 15.0 statistical software (SPSS Inc., Chicago, Ill., USA). Continuous data were expressed as means 6 SD, and categories data as percentages. Continuous variables were compared using Student’s t-test, or ANOVA when appropriate. Furthermore, Pearson’s and Spearman’s (for nonnormally distributed data) coefficients of correlation were used where appropriate. All of the reported P values were two-sided with statistical significance evaluated at 0.05.Results Clinical CharacteristicsThe clinical data of the 85 participants are presented in Table 1. There was no difference in age, gender distribution, blood pressure, blood glucose/NT-proBNP levels, or kidney function among the 3 groups. None was found to have plasma NT-proBNP .200 pg/ml. Blood lipid levels between groups were also similar, except that triglycerides in patients with severe CAD were higher. The proportions of hypertensive subjects were 15 in mild CAD group, 22 in severe CAD group, and 20 in control group (P value, 0.66). There was no difference in history of medical therapy between the 3 groups. Of the 60 CAD patients, 17 had exclusively left anterior descending coronary artery (LAD) stenosis, and 10 had exclusively left circumflex coronary artery (LCX) or right coronary artery (RCA) stenosis. 33 had multiple-vessel disease. Of all the patients, 33 were successfully treated by percutaneous coronary intervention with stent implant, while 7 patients needed subsequent coronary arterial bypass grafting surgery.VVI AnalysisFor the assessment of longitudinal atrial deformation, twodimensional grey-scale image of apical 4-chamber view was obtained under VVI mode with highest possible frame rate and a stable electrocardiogram recording. Special attention was paid to avoid foreshortening the atrium and to gain a reliable delineation of the atrial endocardial border. Cine loops with 2? consecutive heart cycles during breath hold were acquired and saved digitally. Strain analysis of LA and RA was performed offline with Siemens syngo US workplace (version 2, Siemens Medical Solutions USA). After manually defining the endocardial borderEchocardiographic FeaturesConventional transthoracic echocardiographic parameters of the study population are presented in Table 2. All the subjects had normal LV diastolic and systolic dimensions. 2 patients with severe CAD were found with mild decreased LV systolic function (LVEF 45?0 ). However, there was no significant difference in LVEF or LVFS between 3 groups. The LA dimensions in control, mild CAD and severe CAD groups were 36.3664.07 mm,Atrial Deformation and Coronary Artery DiseaseFigure 1. Left atrial longitudinal strain/strain rate curves obtained from an apical four-chamber view. es: peak atrial longitudinal strain during ventricular systole, ea: atrial strain at the onset of P-wave on electrocardiography, SRs: peak left atrial strain during LV systole, SRe: peak left atrial strain during early LV diastole, SRa: peak left atrial strain during late LV diastole. doi:10.1371/journal.pone.0051204.gTable 1. Baseline clinical data.Variablecontrol group (n = 25)mild CAD grou.
