Evaluation Of Right Atrial Function In Patients With Pulmonary Hypertension By Left Atrial Tracking Technique

Objective:To probe into the evaluation of Right atrial(RA)volume trackingmethod(LAVT)on the assessment of right atrial function in patients with PulmonaryHypertension.Methods:60patients were divided into3subgroups:mild（Ⅰ）,moderate（Ⅱ）and severe（Ⅲ）group according to the PASP.30normal individuals were enrolled asthe control group.To obtain dynamic apical four chamber view images.Image of apicalfour-chamber views were obtained by two-dimensional echocardiography.Right atrialvolume-time curve of bi-plane view was obtained by LAVT technique.RA maximalvolume(RAVmax),RA pre-systolic volume(RAVpre),RA minimal volume(RAVmin)，systolic RA filling rate(dv/dtS)，early diastolic RA emptying rate(dv/dtE)and latediastolic RA emptying rate(dv/dtA)were derived using LAVT.RA passive emptyingvolume(RAVp),RA passive emptying fraction(RAVpEF),RA active emptyingvolume(RAVa),RA active emptying fraction(RAVaEF),RA total emptyingvolume(RAVt),RA total emptying fraction(RAVtEF)were calculated. All RA volumemeasurements were corrected by body surface area into RA volumeindex(RAVI).Adopt double doppler imaging (TDI) real-time technology in the samecardiac cycle measure a [isovolumetric contraction time (ICT)+ejection time (ET),isovolumetric relaxation time (IRT)], b ejection time (ET), calculate the Tei index.Results:Compared with the healthy group,theRAVImax,RAVImin,RAVIpre,RAVIt、RAVIa、dv/dtS、dv/dvA were higher,and theRAVIp were significant lower different in PH group(P<0.05),There were no significantdifferences in RAVp、RAVaEF、RAVpEF、RAVtEF、dv/dtE between healthy and PHgroup（sP>0.05）.Along with the development of PH, RAVImax、RAVImin、RAVIpre、RAVIt、RAVIa increased but RAVI pdecreased gradually in Ⅰ, Ⅱa nd Ⅲ group, TheRAVImax has shown significant positive correlation with RAVIp、RAVIpre、RAVIt and RAVIa（r=0.665、0.663、0.691、0.672，P<0.05）,RAVaEF has shown positivecorrelation with the RAVtEF（r=0.725，P<0.05）.There was a significant positivecorrelation with dt/dtE and RAVIp（r=0.625，P<0.05）;Tex index increased graduallyinⅠ,Ⅱ and Ⅲ group(P<0.05)， Ⅲ group is significantly higher than Ⅰ, Ⅱgroup(P<0.05).The RAVImax、RAVImin、RAVIpre、RAVIt、RAVIa、dv/dtS、dv/dtAhave shown significant positive correlation with the Tei index(r=0.628、0.625、0.620，0.531、0.582、0.633、0.592p<0.05）.Conclusions:1.Right ventricular diastolic and systolic function were decreases in patients withPulmonary Hypertension，in order to ensure the right ventricular filling right atriumfunction changed, the right atrial reservoir function,conduit function and booster pumpfunction.2.LVAT as a endocardial tracking technology can quantitatively reflect thepulmonary hypertension right atrium function changes,theRAVImax,RAVImin,RAVIpre,RAVIt,RAVIa,dv/dtS,dv/dvA were higher meansreservoir function and booster pump function increase, and the RAVIp were lowermeans conduit function reduce.3.Left atrial tracking technology is a new better noninvasive method for evaluatingright atrial function,it can indirectly reflect the pulmonary hypertension with rightventricular function changes.