To Evaluate The Diagnostic Value Of Left Atrial Strain For Left Ventricular Diastolic Dysfunction In Patients With Coronary Heart Disease By Speckle Tracking Imaging

Objective:Two-dimensional spot tracking imaging(2D-STI)was used to evaluate the left atrial temporal function in patients with coronary heart disease(CHD),in order to explore left atrial strain diagnostic value for left ventricular diastolic dysfunction(LVDD).Methods:According to ASE/EACVI criteria,89 CHD patients with normal left ventricular ejection fraction(LVEF)were divided into normal left ventricular diastolic function group(n = 38)and LVDD group(n = 51),Two-dimensional and real-time three-dimensional echocardiography was used to measure cardiac structural and functional parameters.The left atrial strain parameters were measured by 2D-STI,compare the differences between the above two groups.The independent risk factors of LVDD were screened out by binary Logistic regression analysis.Plot the ROC curve and evaluate the diagnostic value of each parameter for LVDD.Results:1.There were no significant differences between the two groups between the LVEF,left ventricular end-diastolic diameter(LVEDd),left ventricular end-diastolic volume(LVEDV),Interventricular septal end-diastolic diameter(IVSDd),left ventricular posterior wall end-diastolic diameter(LVPWDd),and LASct(all P > 0.05).The early diastolic mitral annular velocity(septal e’and lateral e’),LASr and LAScd in normal group were higher than those in LVDD group,The left atrial volume index(LAVI),the ratio of early diastolic mitral velocity to mean mitral annular velocity(E/e ’),and tricuspid regurgitation velocity(TRV)in the LVDD group were higher than those in the normal group(all P < 0.05).2.The results of binary logistic regression analysis showed that septal e’,sidewall e’,LAVI,E/e’,TRV,LASr and LAScd were independent influencing factors for the occurrence of LVDD in patients with CHD with normal LVEF(all P<0.05).3.ROC curve analysis showed that the area under the curve(AUC)of septal e ’,lateral e ’,LAVI,E/e ’,TRV,LASr and LAScd for the diagnosis of LVDD in CHD patients with normal LVEF were 0.623,0.676,0.935,0.818,0.878,0.928 and 0.914,respectively.The best cut-off values of LASr and LAScd were 32.25% and 15.50%,respectively.De Long test results showed that the AUC of LASr was higher than that of E/e ’,septal e ’and lateral wall e’.The AUC of LAScd was higher than that of septal e ’and lateral e’(all P <0.05).Conclusion:2D-STI can better detect the changes of left atrial phase function,LASr and LAScd have certain clinical value for diagnosing the occurrence of LVDD in patients with normal LVEF CHD.