Study Of Two-dimention Speckle Tracking Echocardiography In Evaluating Left Atrial Function In Patients With Heart Failure

Objective:The left atrial volume were measured in patients with heart failure by real-time three-dimentionalechocardiography and the change rules of the left atrial function were observed; The left atrial strain andstrain rate were acquired in patients with heart failure by speckle tracking echocardiography(STE) andquantitative evaluation were performed; The correlation between left atrium longitudinal strain and strainrate and left atrial function were compared to testify the accuracy,feasibility and reliablity of STE forevaluating left atrial function in patients with heart failure.Methods:Seventy-two heart failure patients were enrolled,there were thirty heart failure patients with normalejection fraction(HFNEF group) and thirty-one heart failure patients with reduced ejection fraction(HFREFgroup), eleven patients were exclude(six patients were exclude for valvular heart disease or valve operationleading to myocardium cannot be traced clearly and actually; five patients were excluded for poor imagequality due to serious pulmonary diseases). And thirty-two healthy cases regarded as the control group.Left atrium dimension(LAD), left ventricular end diastolic dimension(LVEDD), left ventricular endsystolic dimension(LVESD),left ventricular end diastolic volume(EDV), left ventricular end systolicvolume(ESV) were measured by conventional echocardiography in all patients and left ventriculat ejectionfraction(LVEF) were calculated automatically by Simpson’s method. The left atrial maximal, minimal andpre-systolic volume (LAVmax, LAVmin and LAVpre),left atrial ejection fraction (LAEF), left atrialpassive ejection fraction(LAPEF), and left atrial active ejection fraction (LAAEF) were measured byreal-time three-dimentional echocardiography(RT-3DE). The strain and strain rate curve were acquired ineach left atrial segment with STI, and the mean value of the peak strain and strain rate of systolic, early andlate diastolic of left atrium were recorded.Results:1.The difference in gender,age,heart rate,body mass index had no statistical significance among thecontrol group, HFNEF and HFREF group(P all>0.05). LAD showed a tendency to decrease among thethree group(P all<0.05). LVEDD, EDV, ESV had no statistical significance between HFNEF and controlgroup(P all>0.05).Compared control and HFNEF group,LVEDD, LVESD,EDV,ESV of HFREF groupincreased (P all<0.05).LVEF showed a tendency to increase among the three groups(P all<0.05).2.Compared with control group, LAVmax, LAVmin, LAVpre of HFNEF and HFREF group increasedsignificantly(P<0.05),No statistical significance was found between HFREF and HFNEF group(Pall>0.05).LAEF,LAPEF and LAAEF showed a tendency to decrease among the control group, HFNEF andHFREF group.3.Strain and strain rate in reservoir phase and passive conduit phase and srain rate in active pump phase showed a tendency to decrease and strain in active pump phase showed no significant changesamong the three group. In reservoir phase LAEF and SSRM correlated well (r=0.76，P <0.01), in passiveconduit phase LAPEF and ESRM (r=-0.60，P <0.01) correlated well, in active pump phase significantcorrelation was found between LAAEF and ASRM (r=-0.60，P <0.01).Conclusion:1.LAEF,LAPEF and LAAEF showed a tendency to decrease among the control group, HFNEF andHFREF group.2.Strain and strain rate in reservoir phase and passive conduit phase and strain rate in active pumpphase showed a tendency to decrease and strain in active pump phase showed no significant changesamong the three group. STE can reflect left atrium function of patients with heart failure accurately andsensitively.3.left atrium function and strain rate in middle segment of left atrium correlated well.4.Systolic and diastolic function of the atrium decreased in HFNEF and HFREF patients.