Integrated assessment of left atrial function and C-reactive protein levels for severity of coronary artery ectasia: observational case–control study

Abstract Background Coronary artery ectasia (CAE) refers to the expansion of a specific segment of an epicardial coronary artery that poses a significant risk for cardiovascular events and death persisting despite percutaneous coronary intervention. We sought to investigate left atrial mechanical functions through 2D strain analysis in individuals with isolated CAE and compare them to controls with normal coronary angiography, examining its correlations with C-reactive protein (CRP) levels and CAE severity. Methods The studied patients undergone selective coronary angiography followed by laboratory evaluation of quantified highly sensitive (hs) CRP then complete transthoracic echocardiography (TTE). The left atrium (LA) longitudinal strain by 2D and hs CRP were compared between 30 individuals with CAE and 50 control participants with normal coronary angiography. Results CAE individuals had significantly increased CRP than control patients ( p value = 0.001) and decreased LA longitudinal and contractile function ( p value = 0.001). Moreover, there were more significant LA functions in CAE with high CRP than CAE with normal CRP. In addition, the LA reservoir function by 2D strain had significant correlation with Markis classification ( r = 0.369, p value 0.045). In addition, left atrial reservoir strain showed a strong correlation with CRP levels. Conclusion Impaired LA phasic function and increased CRP in patients with CAE. The LA phasic function impairment is more pronounced in individuals with CAE and elevated CRP, and LA reservoir function is significantly linked to the severity of CAE. The CRP and the LA function by 2D strain is a simple and valuable method for assessment of CAE and gauging its severity and identifying patients at the risk of developing heart failure early.