Application Of Two Dimensional Speckle Tracking Echocardiography In Evaluating Left Atrial Function In Patients With Pulmonary Hypertension

Objective: To evaluate left atrial function with two dimensional speckle tracking echocardiography in patients with pulmonary hypertension and compared with the results of real-time three-dimensional echocardiography. Methods:30 cases of pulmonary hypertension patients were included in this study and 33 healthy cases were regarded as control group. Routine parameters such as the dimension of LA and RV, thickness of right ventricular free wall, right ventricular end-diastolic area, right ventricular end-systolic area and the maximal velocity of tricuspid regurgitation were measured by conventional echocardiography. The longitudinal strain and strain rate of left atrial’s various segments were measured by two dimensional speckle tracking echocardiography. LA ejection fraction was measured by real-time three-dimensional echocardiography. Results:Left atrium diameter,right ventricular diameter, thickness of right ventricular free wall of PH group were increased compared with control group, the difference was statistically significant (P< 0.001); RVFAC and RVEF of PH group were less increased compared with control group, the difference was statistically significant (P<0.05); Compared with control group, LAVmax, LAVmin,and LAVpre of PH group were increased(P<0.05), LAEF, LAPEF and LAAEF of PH group were reduced, the statistical significance was found between pH group and control group(P<0.001); Compared with the control group, the strain and strain rate in the rest phase of PH group showed a reduction except for ESB, ESAP, ASB and ASM. In reservoir phase LAEF and SSM correlated well(r=0.752, P<0.01), in passive conduit phase LAPEF and ESRM correlated well(r=-0.733, P<0.01), in active pump phase significant correlation was found between LAAEF and ASRM(r=-0.320, P<0.05). Conclusion: Both Three-dimensional speckle tracking and STE can evaluate the left atrial function of the patients with moderate and severe pulmonary hypertension, however, STE can reflect left atrial function in patients with pulmonary hypertension noninvasively, accurately and reliably by measured the strain and strain rate of the left atrium and provide a new examination method for clinical.