Left Atrium Volume Index and Aortic Stiffness as Predicting Factors for Severity of Coronary Artery Disease

Abstract
Background: Recently, it has been demonstrated that left atrial distension and aortic stiffness have a predictive value for cardiovascular outcomes especially in high-risk, elderly, and hypertensive adults.
Aim of Study: Evaluation of predictive value of Left Atrium Volume Index (LAVI) and aortic stiffness for severity of angiographic pattern of Coronary Artery Disease (CAD).
Methods: A prospective observational cohort single-center study conducted from May 2016 to May 2017, at Cardiovas-cular Medicine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 100 consec-utive adult patients of both genders who were diagnosed with chronic stable coronary artery disease and were candidates for invasive coronary angiography. Each patient was subjected to echocardiographic assessment for Left Atrium Volume Index (LAVI) and Aortic Stiffness Index (ASI) followed by invasive coronary angiography for assessment of severity of coronary artery disease by Gensini score. Patients were classified into 3 groups by Gensini score: Group I (gensini score equal zero), Group II (Gensini score more than 0 and less than 20) and Group III (Gensini score equal or more than 20).
Results: The prevalence of severe CAD was higher among patients with high LAVI (p-value 0.002) and ASI (p-value 0.05). The significant positive relation between LAVI and Gensini score was mainly between Groups II, III (non-severe and severe coronary artery disease). ASI was more sensitive than LAVI for detection of the severity of CAD as ASI showed statistically significant positive strong correlation with the coronary angiographic score (p=0.001) while LAVI showed no significant correlation with the coronary angiographic score (p=0.061). The LAVI carried sensitivity of 67% and specificity of 49.5% in predicting CAD with cutoff value >19.5. While The ASI carried sensitivity of 66.7% and spe-cificity of 21% in predicting CAD with cutoff value >2.88.
Conclusion: It was demonstrated that there is significant elevation at aortic stiffness index and left atrium volume index within the group of patient with the higher Gensini score. So ASI and LAVI could be used as promising factors for evalu-ation of the severity of coronary artery disease.