Evaluation of left atrial function in hypertensive patients by three-dimensional speckle tracking imaging

doi:10.3877/cma.j.issn.1672-6448.2022.02.010

Abstract

Abstract:

Objective

To evaluate the characteristics of left atrial (LA) volume, ejection fraction, and strain parameters at different phases in hypertensive patients with or without left ventricular remodeling by three-dimensional speckle tracking echocardiography.

Methods

A total of 90 hypertension patients (40 in left ventricular remodeling group and 50 in non-remodeling group) and 40 healthy subjects who underwent cardiac ultrasound examination at Sichuan Provincial People's Hospital from January 2020 to August 2020 were collected. Standard three-dimensional and two-dimensional transthoracic echocardiography images were collected and parameters were analyzed. Conventional cardiac parameters, LA longitudinal and circumferential strain, LA ejection fraction, and the global longitudinal strain (GLS) of the left ventricle were compared among the three groups, and the correlations between these parameters were analyzed.

Results

Compared with healthy subjects, longitudinal strain of LA conduit and contraction phases decreased significantly in the non-remodeling hypertension group (11.7%±3.0% vs 14.6%±1.4%, 12.6%±3.4% vs 15.2%±2.2%, P＜0.05), while the circumferential strain of reserve, conduit, and contraction phases increased significantly (34.3%±6.3% vs 29.0%±5.1%, 14.6%±3.1% vs 12.4%±2.1%, and 19.3%±4.4% vs 16.6%±2.3%, respectively; P＜0.05 for all). The volumes at different phases were significantly increased in the remodeling hypertensive group, while LA ejection fraction and longitudinal and circumferential strain were significantly decreased (P＜0.05 for all). For hypertensive patients, the LA longitudinal and circumferential strain were significantly correlated with LA ejection fraction of different phases and GLS (r=0.35-0.77, P＜0.05 for all).

Conclusion

The complex LA function can be evaluated by three-dimensional speckle tracking echocardiography, including the quick acquisition of LA ejection fraction and longitudinal and circumferential strain at different phases. Circumferential strain is one of the most important LA parameters . Three-dimensional speckle tracking imaging can provide valuable information for early detection of left atrial function changes and early clinical intervention in patients with hypertension.

Key words: Hypertension, Three-dimensional speckle tracking imaging, Left atrial function, Echocardiography

Qingfeng Zhang, Yi Wang, Wenhua Li, Hongmei Zhang, Geqi Ding, Xuebing Liu, Zhiyu Guo, Yi Sang, Chunmei Li, Yan Deng, Lixue Yin. Evaluation of left atrial function in hypertensive patients by three-dimensional speckle tracking imaging[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(02): 150-155.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.02.010

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Figures/Tables 4

References 17

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参数	正常对照组（n=40）	非左心室重构组（n=50）	左心室重构组（n=40）	F/χ²值	P值
年龄（岁）	51±9	50±10	54±7	0.52	0.97
男/女（例）	23/17	28/22	25/15	0.98	0.23
BSA（m²）	1.68±0.22	1.71±0.11	1.74±0.15	1.24	0.15
LVEF（%）	0.69±0.05	0.73±0.04	0.66±0.06	0.81	0.21
SBP（mmHg）	110±18	136±13^a	152±21^ab	20.32	＜0.01
高血压持续时间≥5年［例（%）］	-	20（40.0）	18（45.0）	1.85	0.09
GLS（%）	22.4±1.3	21.9±1.6	17.5±2.5^ab	12.98	＜0.01
LA（mm）	33.6±1.9	34.1±2.2	36.3±2.7^ab	7.82	0.04
LVPW（mm）	9.6±0.7	10.0±0.6	11.8±1.0^ab	9.13	0.04
LVD（mm）	44.7±2.8	46.5±2.5	49.9±3.7	2.17	0.07
IVS（mm）	10.3±0.5	11.1±0.7^a	12.9±1.1^ab	5.49	0.02
E（m/s）	0.97±0.11	0.79±0.16^a	0.71±0.12^a	13.74	＜0.01
A（m/s）	0.85±0.19	0.87±0.15	0.99±0.18	0.66	0.38
e（cm/s）	0.16±0.03	0.12±0.04^a	0.08±0.03^a	21.47	＜0.01
a（cm/s）	0.11±0.02	0.13±0.03	0.11±0.03	0.91	0.22
E/e	5.9±1.5	7.9±2.0^a	9.9±1.9^a	11.90	＜0.01
LVMI（g/m²）	102±10	117±10^a	147±12^ab	27.87	＜0.01

参数	正常对照组（n=40）	非左心室重构组（n=50）	左心室重构组（n=40）	F/χ²值	P值
年龄（岁）	51±9	50±10	54±7	0.52	0.97
男/女（例）	23/17	28/22	25/15	0.98	0.23
BSA（m²）	1.68±0.22	1.71±0.11	1.74±0.15	1.24	0.15
LVEF（%）	0.69±0.05	0.73±0.04	0.66±0.06	0.81	0.21
SBP（mmHg）	110±18	136±13^a	152±21^ab	20.32	＜0.01
高血压持续时间≥5年［例（%）］	-	20（40.0）	18（45.0）	1.85	0.09
GLS（%）	22.4±1.3	21.9±1.6	17.5±2.5^ab	12.98	＜0.01
LA（mm）	33.6±1.9	34.1±2.2	36.3±2.7^ab	7.82	0.04
LVPW（mm）	9.6±0.7	10.0±0.6	11.8±1.0^ab	9.13	0.04
LVD（mm）	44.7±2.8	46.5±2.5	49.9±3.7	2.17	0.07
IVS（mm）	10.3±0.5	11.1±0.7^a	12.9±1.1^ab	5.49	0.02
E（m/s）	0.97±0.11	0.79±0.16^a	0.71±0.12^a	13.74	＜0.01
A（m/s）	0.85±0.19	0.87±0.15	0.99±0.18	0.66	0.38
e（cm/s）	0.16±0.03	0.12±0.04^a	0.08±0.03^a	21.47	＜0.01
a（cm/s）	0.11±0.02	0.13±0.03	0.11±0.03	0.91	0.22
E/e	5.9±1.5	7.9±2.0^a	9.9±1.9^a	11.90	＜0.01
LVMI（g/m²）	102±10	117±10^a	147±12^ab	27.87	＜0.01

参数	正常对照组（n=40）	非左心室重构组（n=50）	左心室重构组（n=40）	F值	P值
LAVmin（ml）	17.0±4.3	19.9±4.2^a	28.5±6.3^ab	32.19	＜0.01
LAVmax（ml）	42.9±6.7	47.8±8.8^a	51.0±10.9^a	7.88	0.02
LAVpre（ml）	32.0±7.8	32.8±8.2	41.4±9.9^ab	12.69	＜0.01
LAVImax （ml/m²）	25.6±4.1	29.2±4.8^a	31.6±6.7^a	8.27	0.02
LA-TAEF（%）	0.51±0.03	0.57±0.04^a	0.43±0.05^ab	11.56	＜0.01
LA-PAEF（%）	0.33±0.04	0.27±0.06	0.17±0.04^ab	20.14	＜0.01
LA-AAEF（%）	0.37±0.05	0.41±0.03	0.28±0.04^ab	10.95	0.03
LAsr（%）	24.8±4.3	23.6±5.2	16.3±4.4^ab	13.79	0.02
LAscd（%）	14.6±1.4	11.7±3.0^a	7.2±4.1^ab	34.11	＜0.01
LAsct（%）	15.2±2.2	12.6±3.4^a	9.2±3.4^ab	28.72	＜0.01
LAsr-c（%）	29.0±5.1	34.3±6.3^a	19.2±5.3^ab	37.20	＜0.01
LAscd-c（%）	12.4±2.1	14.6±3.1^a	6.7±3.4^ab	28.54	＜0.01
LAsct-c（%）	16.6±2.3	19.3±4.4^a	13.2±4.1^ab	19.23	＜0.01

参数	正常对照组（n=40）	非左心室重构组（n=50）	左心室重构组（n=40）	F值	P值
LAVmin（ml）	17.0±4.3	19.9±4.2^a	28.5±6.3^ab	32.19	＜0.01
LAVmax（ml）	42.9±6.7	47.8±8.8^a	51.0±10.9^a	7.88	0.02
LAVpre（ml）	32.0±7.8	32.8±8.2	41.4±9.9^ab	12.69	＜0.01
LAVImax （ml/m²）	25.6±4.1	29.2±4.8^a	31.6±6.7^a	8.27	0.02
LA-TAEF（%）	0.51±0.03	0.57±0.04^a	0.43±0.05^ab	11.56	＜0.01
LA-PAEF（%）	0.33±0.04	0.27±0.06	0.17±0.04^ab	20.14	＜0.01
LA-AAEF（%）	0.37±0.05	0.41±0.03	0.28±0.04^ab	10.95	0.03
LAsr（%）	24.8±4.3	23.6±5.2	16.3±4.4^ab	13.79	0.02
LAscd（%）	14.6±1.4	11.7±3.0^a	7.2±4.1^ab	34.11	＜0.01
LAsct（%）	15.2±2.2	12.6±3.4^a	9.2±3.4^ab	28.72	＜0.01
LAsr-c（%）	29.0±5.1	34.3±6.3^a	19.2±5.3^ab	37.20	＜0.01
LAscd-c（%）	12.4±2.1	14.6±3.1^a	6.7±3.4^ab	28.54	＜0.01
LAsct-c（%）	16.6±2.3	19.3±4.4^a	13.2±4.1^ab	19.23	＜0.01

统计值	LAsr	LAscd	LAsct	LAsr-c	LAscd-c	LAsct-c
TAEF
r值	0.66	0.64	0.58	0.69	0.77	0.57
P值	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01
PAEF
r值	0.61	0.58	0.51	0.54	0.56	0.48
P值	＜0.01	＜0.01	0.002	＜0.01	＜0.01	0.01
AAEF
r值	0.59	0.70	0.36	0.533	0.71	0.39
P值	＜0.01	＜0.01	0.03	＜0.01	＜0.01	0.02
GLS
r值	0.38	0.59	0.39	0.46	0.66	0.35
P值	0.03	＜0.01	0.02	＜0.01	＜0.01	0.048

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