Evaluation Of Left Atrial Function In Patients With Coronary Heart Disease By Real-time Three-dimensional Echocardiography

Aim:1. To explore the value of left atrial function in patients with coronary heart disease by real-time three-dimensional echocardiography(RT-3DE).2. To explore the relations of left atrial volumes by RT-3DE and left ventricular diastolic function.Methods: 1. Subjects: 52 healthy volunteers served as control group(group A). 44 patients with coronary heart disease who were confirmed by coronary angiography served as case group, which were classified into group B(<15.02ml) and group C(?15.02ml) according to the size of left atrial minimal volume.2. Equipments: Using GE Vivid E9 Demision ultrasound system with Echo PAC 11.2 work station.3. Measurement: Left atrial maximal volume(LAVmax), left atrial minimal volume (LAVmin), left atrial presystolic volume(LAVpre) were calculated by RT-3DE and two-dimensional echocardiography(2DE). And left atrial eject fraction(LAEF), left atrial passive emptying fraction(LAEFpassive), left atrial active emptying fraction(LAEFactive) were calculated. Left atrial volumes and function were evaluated and compared using both RT-3DE and 2DE. The correlations of RT-3DE-derived parameters with the ratio of transmitral to annular velocities during early filling(E/e') were analyzed.Results:1. Significant correlations of RT-3DE and 2DE for left atrial volumes(group A, r=0.909, P<0.05; group B, r=0.969, P<0.05; group C, r=0.918, P<0.05). LAV and function showed no significant difference by both techniques in group A and group B(P>0.05), while in group C, the LAVmin and LAVpre were significantly lower by RT-3DE than 2DE(P< 0.05). TAEF were significantly higher by RT-3DE than 2DE in group C(P< 0.05).2. For the comparisons of RT-3DE-derived LAV and function, the TAEF and LAEFactive were significantly higher in group B than group A(P<0.05), while the other parameters showed no significant difference(P>0.05); the LAVmax, LAVmin, LAVpre were significantly higher in group C than group A(P<0.05), while TAEF and LAEFpassive were significantly lower(P<0.05);the LAVmax, LAVmin, LAVpre were significantly higher in group C than group B(P<0.05), while TAEF, LAEFpassive, LAEFactive were lower(P<0.05).3. Significant correlations of RT-3DE-derived left atrial volume with E/e' ratio were found(LAVmax, r=0.388, P<0.05; LAVmin, r=0.349, P<0.05; LAVpre, r=0.393, P<0.05).Conclusions:1. Left atrial phasic volumes and function are measured accurately by RT-3DE in patients with coronary heart disease.2. The left atrial volumes which is measured by RT-3DE can evaluate the changes of left ventricular diastolic function.