Study On Left Atrial Systolic Function In Patients With Uremia Using Strain Rate Imaging And Real-time Three Dimensional Echocardiography

Objective: To evaluate left atrial(LA) systolic function in patients with uremia by strain rate imaging(SRI)and real-time three dimensional echocardio graphy(3-DE).Methods: The uremic patients as research subjects, 30 uremic patients as the experimental group A,which the internal diameter of LA (LAD) were normal with tow-dimensional ultrasound measurement; 44 uremic patients as experimental group B,which mass index of left ventricle(LVMI)were normal. 30 healthy volunteers as the control group.The parameter of the conventional echcardiographic,SRI and 3-DE were repectively measured to the experimental group A,B and the control group,obtained parameters include: parameters of doppler echcardiographic:the peak E velocity(E), and the peak A velocity(A), E/A ratio, isovolumic relaxation time(IRT),velocity time integral of A wave(A-VTI) ; parameters of SRI:the left atrial systolic strain rate at left atrial wall top segment of Atrial septal, lateral, inferior, anterior, posterior(SRa);parameters of 3-DE:the maximun left atrial volume (LAVmax),mininum left atrial volume(LAVmin), left atrial volume before systole(LAVp) were determined by 3-DE. calculate left atrial ejection fraction(LAEF) and left atrial systolic volume(LASV). the internal diameter of LA(LADd) were measured to the experimental group A and the control group by tow-dimensional; posterior wall of interventricular septal thickness(IVST),the internal diameter of left ventricle(LVDd)and left ventricle (LVPWT) were measured to the experimental group B and the control group by tow-dimensional. calculate mass index of left ventricle (LVMI). Results: 1. LAD,E/A,IRT,A-VTI were not significantly different between the experimental group A and the control group,but the left atrial strain rate(SRa),left atrial systolic volume(LASV) and left atrial ejection fraction(LAEF) are significant differrent (P < 0.05). 2. E/A,IRT,A-VTI were not significantly different,mass index of left ventricle(LVMI) were at the normal value range and had no significant differences between the experimental group B and the control group,but the left atrial strain rate(SRa) , left atrial systolic volume(LASV) and left atrial ejection fraction(LAEF) are significant differrent (P < 0.05). 3. parameters of SRa, LAEF and LASV in the experimental groups are higher than those of the control groups.Conclusions: The results show the LADd were normal and LVMI no change in patients with uremia,and left ventricular diastolic function did not significantly change by the conventional ultrasonic:but left atrial systolic function can happen obvious changes by SRI and 3-DE in patients with uremia.Left ventricular diastolic dysfunction were predicted in directly.Ear- ly diagnosis may guide clinical treatment taken timely and effectively.It was an important reference that early clinical diagnosis and timely treatme- nt and prognosis .