Assessment Of The Changes Of Left Atrial Function After PCI By STI In AMI Patients

ObjectiveTo explore the changes of left atrial function in acute myocardial infarction(AMI)patients by the speckle tracking imaging and two-dimensionalconventional echocardiography. To analyze the effects of PCI on the structureand function of left atrial in AMI patients, approach the relations of left atrialremodeling and left ventricular function，and assess the clinical values of the leftatrial remodeling and functions by speckle tracking imaging.MethodsIndicators of left atrial function of30AMI patients were observedpreoperative, postoperative1week and1month after senting impantation wereobserved,and were compared with30normal cases(contral group).Two-dimensional echocardiography and Simpson’s method was used to measureLVEF、E、A、E/A、LAVmin、LAVmax、LAVpre-A and LAPEF、LAAEF．STIwas used to detect strain rate curve of left atrial wall, then peak SR weremeasured at each left atrial segment (lateral, posterior, anterior, inferior andseptum), and mean peak systolic SR(SRs), early diastolic SR(SRe) and latediastolic SR (SRa) were calculated by averaging the results for each left atrialsegment(mSRs、mSRe、mSRa).Results1、Comparison of left ventricular conventional indicatorsCompared with the control group, AMI patients before PCI, after PCI1 week and1month LVEF, E, E/A decreased, A increased, the differences werestatistically significant (P<0.05); Compared with AMI patients before PCI,1week after PCI whose LVEF、E、E/A、A showed no significant difference(P>0.05); Compared with AMI patients before PCI and1week after PCI,1month after PCI whose LVEF、E、E/A increased, A decreased, the differenceswere significant (P<0.05).2、Comparison of left atrial reserve function indicatorsCompared with the control group, AMI patients before PCI, after PCI1week and1month LAVmin, LAVmax, LAVp increased, mSRs decreased，thedifferences were statistically significant (P<0.05); Compared with AMI patientsbefore PCI,1week after PCI whose left atrial reserve function indicatorsshowed no significant difference (P>0.05); Compared with AMI patients beforePCI and1week after PCI,1month after PCI whose LAVmin、LAVmax、LAVpdecreased, mSRs increased,(P<0.05).3、Comparison of left atrial pipe function indicatorsCompared with the control group, AMI patients before PCI, after PCI1week and1month LAPEF, mSRe decreased,the differences were statisticallysignificant (P<0.05); Compared with AMI patients before PCI,1week after PCIwhose left atrial pipe function indicators showed no significant difference(P>0.05); Compared with AMI patients which before PCI and1week after PCI,1month after PCI whose LAPEF、 mSRe increased, the differences weresignificant (P<0.05)4、Comparison of left atrial pumping function indicatorsCompared with the control group, AMI patients before PCI, after PCI1week and1month LAAEF, mSRa increased, the differences were statisticallysignificant (P<0.05); Compared with AMI patients before PCI,1week after PCIwhose left atrial assist pumping function indicators showed no significantdifference (P>0.05); Compared with AMI patients which before PCI and1week after PCI,1month after PCI whose LAAEF、mSRa decreased, the differenceswere significant (P<0.05)6、Correlation analysis between the indicatorsThe left atrium strain rate index SRs and SRe, SRs and SRa of the controlgroup were both negative correlation(r1=-0.53,r2=-0.48,P<0.01);AMI patientsbefore PCI, after PCI1week and1month the mSRs and mitral A peak werepositively correlated(r1=0.48,r2=0.50,r3=0.51,P<0.01),mSRs and Vmax werenegative correlated(r1=-0.53,r2=-0.47,r3=-0.44,P<0.01); AMI patients before PCI,after PCI1week and1month the mSRe and mitral E peak were negativecorrelated(r1=-0.62,r2=-0.54,r3=-0.49,P<0.01),the mSRe and the E/A ratio werenegative correlated(r1=-0.58,r2=-0.56,r3=-0.53,P<0.01),the mSRe and LAPEFwere positively correlated(r1=0.49,r2=0.51,r3=0.55,P<0.01); AMI patients beforePCI, after PCI1week and1month the mSRa and mitral A peak of werepositively correlated(r1=0.52,r2=0.48,r3=0.47,P<0.01), the mSRa and the E/Aratio were negative correlated(r1=-0.61,r2=-0.55,r3=-0.51,P<0.01), the mSRaand LAAEF were positively correlated (r1=0.61,r2=0.52,r3=0.48,P<0.01).Conclusions1、The reserve and pipe function of left atrial in acute myocardial infarctionpatients were lower than that of the control group; the pump function of left atrialwas higher than that of the control group.2、After percutaneous coronary intervention,the left atrial function of acutemyocardial infarction patients was improving.3、Left atrial function has a significant correlation with left ventricularfunction in acute myocardial infarction patients.4、Srain rate index can evaluate accurately the changes of left atrialfunction in acute myocardial infarction patients by STI.