Evaluation Of The Relationship Between Atrial Septal Thickness And Left Atrial Function In Patients With Hypertension By Two-dimensional Speckle Tracking Technique Combined With Conventional Ultrasound

Objective: Two-dimensional speckle tracking technique(2D-STI)was used to evaluate the relationship between left atrial function and atrial septal thickness in patients with essential hypertension.To provide a reliable basis for early clinical intervention in the treatment of hypertension.Methods: Patients with hypertension 86(LAR 42 in left atrial remodeling group and LAN 44 in left atrial non-remodeling group)and 47 healthy subjects were selected.The global peak strain rates of systolic left atrium((mSRs)),early diastolic left atrium((mSRe))and late diastolic left atrium((mSRa))were obtained by 2D-STI.After the longitudinal peak strain(PALS)of the left atrium was obtained.The maximum left atrial volume((LAVmax)),left atrial presystolic volume((LAVpre))and minimum left atrial volume((LAVmin),)were obtained by RT-3DE(real-time three-dimensional volumetric imaging)combined with ECG,and the left atrial passive emptying index(LAEFpassive),left atrial active emptying index(LAEFactive)and total left atrial emptying fraction(LAEF)were calculated.The maximum thickness of interatrial septum((IASTs))and the minimum thickness of interatrial septum((IASTd),)were measured by anatomical M-mode,and the thickening rate of atrial septum ASTDF=(IASTs-IASTd)/ IASTs was calculated.The data of each group were observed,and the correlation between atrial septal thickening rate and left atrial active emptying index,late diastolic average strain rate and total left atrial emptying fraction was analyzed.Results: Compared with control group,mSRs,mSRe,LAEFp and LAEF in(LAN)group were lower,mSRa,LAEFa and ASTDF were higher in LAR group(P < 0.05),mSRs,mSRe,LAEFp and LAEF were lower and mSRa,LAEFa and ASTDF were higher in LAR group than those in LAN group(P < 0.05).PALS in LAR group and LAN group were lower than that in control group,with statistical significance(P<0.05);PALS in the LAR group was lower than that in the LAN group,and the difference was statistically significant(P<0.05).LASI in the LAR group and the LAN group were significantly higher than that in the control group,with statistical significance(P<0.05),and the increase of LASI in the LAR group was more obvious,with statistical significance(P<0.05).There was a positive correlation between ASTDF and LAEFa(r = 0.506,P < 0.001).There was a positive correlation between ASTDF and LAEF(P < 0.001).There was a negative correlation between ASTDF and LASI(r = 0.402,P < 0.001).There was a negative correlation between ASTDF and mSRa,and there was a negative correlation between LASI and LAEFa(P < 0.001).There was a significant negative correlation between LASI and LAEF(r = 0.523,P <0.001).There was a positive correlation between LASI and mSRa(r = 0.442,P <0.001).There was a weak positive correlation between mSRa and LAEFa.Conclusion: In patients with hypertension,left atrial function has begun to decline in the early stage,and two-dimensional speckle tracking technique can detect the changes of left atrial structure and function in the course of essential hypertension.Two-dimensional speckle tracking technique combined with LASI and IAST can reflect the changes of left atrial function in patients with hypertension from different angles,and can be used as a supplementary predictor of early changes of left atrial function.