Evaluation Of Right Atrial Function In Patients With Dilated Cardiomyopathy And Ischemic Cardiomyopathy Using Two-dimensional Speckle Tracking Imaging

ObjectiveTo evaluate right atrial function in patients with dilated cardiomyopathy(IDCM) and ischemic cardiomyopathy (ICM) by using two-dimensional speckle tracking imaging (2D-STI).Materials And MethodsStudy population consisted of31patients with IDCM,30with ICM and30healthy subjects. Left ventricular ejection fraction (LVEF) of ICM and IDCM was from35%～45%. All the subjects had no diseases which may affect the functions of the heart and lung. Each subject had undergone conventional2D echocardiographic examination by using a Philips iE33ultrasound system with a S5-1probe, its frequency was1-5MHz.2D echocardiographic parameters included:left atrial diameter (LAD), left ventricular end diastolic diameter(LVDD), left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), right ventricular end diastolic area(RVEDA), right ventricular end systolic area (RVESA), right ventricular end diastolic internal diameter(RVIDd), right ventricular end systolic internal diameter(RVIDs), tricuspid annular peak early-diastolic velocity(E), tricuspid annular peak systolic velocity by TDI (S’), tricuspid annular plane systolic excursion (TAPSE), and diameter of inferior vana cava (IVC), etc. Right ventricular fractional area change (RVFAC)、right ventricular shortening fraction (RVFS)、E/A、E’A’、E/E’、right ventricular myocardial performance index(RVMPI) and respiratory IVC variability were subsequently calculated. High frame rate2D images were recorded from the apical four chamber view. Right atrial global longitudinal strain (GLS) was calculated using QLAB7.0soft ware. All the data were analyzed by SPSS21.0.,ResultsCompared with the controls, LVEF, TAPSE, RVFAC, RVFS and S’ were found decreased (P<0.05), while MPI showed increased in IDCM and ICM group. There were no significant differences for all above echocardiographic parameters between IDCM and ICM patients. Compared with the controls, right atrial GLS decreased significantly in patients with IDCM and ICM, even much lower in patients with IDCM (P<0.001). Right atrial GLS was positively correlated with TAPSE, while negatively correlated with RVMPI. GLS had good repeatability.ConclusionLeft heart failure could affect the right heart function of IDCM and ICM patients, Measurement of right atrial strain using2D-STI could be used for the assessment of right atrial dysfunction in patients with ICDM and ICM. And right atrial GLS could help the differentiation diagnosis of IDCM and ICM.