Evaluation Of Left Atrial Function In Pregnant Women With Preeclampsia By Speckle Tracking Imaging

Objective: To investigate the effect of preeclampsia(PE)on left atrium(LA)structure and function of pregnant women by Two-dimensional Echocardiography(2DE)and Two-dimensional Speckle Tracking Imaging(2D-STE),thus analyzing the influence of Hypertensive disorders complicating pregnancy(HDCP)on the left atrium of pregnant women further,and screening the high risk factors.Methods: PE womem(group PE,n = 34),healthy women(group NP,n=45)by 2DE were selected,and PE women were divided into 2 groups: mild preeclampsia(group PE 1,n=16)and severe preeclampsia(group PE 2,n=18).Left ventricular ejection fraction(LVEF),stroke volume(SV),left atrium maximum,minimum and shrinkage volume(LAVmax LAVmin LAVp)could be obtained by 2DE,and LAPEF,LAAEF,LAEF,LAEI could be measured.BSA standardized parameters of structure and function.Applied PW and TDI testing the early diastolic peak flow velocity(E),late diastolic peak flow velocity(A),the early peak velocity in the ventricular septal side at the mitral annulus and lateral wall of left ventricle(septal-e,lateral-e),and then calculated E/A value,the E/e ratio.The ventricle systolic strain rate(SRs),early diastolic strain rate(SRe),late diastolic strain rate(SRa)of the segments of LA septum(Sep),LA lateral wall(Lat),LA inferior wall(Inf),LA anterior wall(Ant)and LA posterior wall(Pos)were measured by 2D-STE,and then analyzed the important factors affecting the left atrial structure and function in the HDCP women.Results:1.The results of clinical characteristics: compared with NP group,BSA,BMI,HR increased significantly in other 2 groups(P<0.05).2.1.The results of LA function by 2DE: with respecting to the NP group,LADi,LAEFi and LAVi are statistical differencesnin PE 2 group,and LAPEFi,LAEFi were lower in PE group(P<0.05).2.2.The results of LV function by 2DE: compared to women of NP group,E / A,LVEF were decreased in PE group(P<0.05).3.The results by 2D-STE:(1)SRs of LA septum,anterior wall had statistically significant differences in 3 groups;SRs of LA posterior wall of PE 2 group was significantly lower than that of group NP(P<0.05);SRs of LA lateral wall had statistically significant differences in PE,NP group;SRs of LA inferior wall in basal and middle segment had statistically significant differences in3 groups.(2)Compared to women of NP group,SRe of LA inferior and posterior wall in roof segment,LA posterior wall in middle segment,LA septum had statistically significant differences in PE 2 group,LA inferior wall in middle segment had significantly difference between PE group and NP group.(3)SRa of LA septum,inferior,anterior wall in some segment had differences in PE group and NP group.4.Linear regression equation showed MAP,BMI,BSA,SVi,LVEF,age and E/e were independent predicators of the left atrial configuration and function of HDCP women.Conclusion: The LA structure of preeclampsia women have enlarged,mild preeclampsia women reduce myocardial segments strain function,and sever preeclampsia women’s left heart functional deterioration.Speckle tracking imaging can detect changes in left atrial myocardial segments function of PE women.MAP,BMI,BSA,SVi,LVEF,age and E/e are the main factors influencing the left atrial configuration and function of HDCP women.