Assessment Of The Left Atrial Function In Patients With Iron Deficiency Anemia By Real-time Three-dimensional Echocardiography

Objective : To assess the left atrial function in patients with iron deficiency anemia(IDA)by real-time three-dimensional echocardiography(RT-3DE).Methods:We selected 65 patients with IDA(age 22~65 years)who were diagnosed in the department of hematology,gynecoloy and digestion in our hospital from April2014 to June 2016 to be experimental group,and they were divided into group B(Hb>90 g/L,age 25~65 years,mean 48.8±14.1 years,duration 7 month~15 years)and group C(Hb 60~90 g/L,age 22~62 years,mean 47.6±16.6 years,duration 8 month~14years)according to the degree of hemoglobin.38 patients with IDA were caused by gynecological disease such as uterine leiomyoma,adenomyosis and increased menstrual flow.18 patients with IDA were caused by digestive system disease such as subtotal gastrectomy.Another 9 cases with IDA were caused by unknown reasons.Exclusion of other heart disease,such as congenital factors,diabetes,coronary heart disease,hyperthyroidism,hypertension and so on.Remove of patients who received chemotherapy and radiotherapy after major surgery of gastrointestinal malignant tumors.A family history and other chronic diseases were also discharged.Another 30 people in our hospital from April 2014 to June 2016 were also selected as control group(age25~65 years,mean 48.8±14.1 years).Exclusion of family history and other chronic diseases.Their physical examination,electrocardiogram(ECG),chest radiography,ultrasound echocardiography,and the blood laboratory tests were all normal.An ultrasound system(Vivid E9,GE Medical Health,USA),an M5S-D probe(1.5~4.5MHz),a 4V-D probe(1.7~3.3 MHz)and a related analysis software were used for the study.The parameters of the conventional echocardiography and three-dimensionalechocardiography were measured as following:1.Recorded the gender,age,blood pressure and heart rate of all the participants.The patients should be kept in left lateral position and kept the eupnea.The parameters of the conventional echocardiography were obtained respectively from groups A,B and C.Conventional parameters included left atrial end-systolic diameter(LADs),left ventricular end-diastolic diameter(LVDd),end-diastolic thickness of ventricular septum(IVSTd),end-diastolic thickness of LV posterior wall(PWTd).The paramaters of CDFI included peak E and A of mitralis(E,A),and calculated E/A.2.The parameters of RT-3DE were obtained respectively from groups A,B and C.The parameters included left atrial minimum volume(LAVmin),left atrial maximum volume(LAVmax),left atrial pre-atrial contraction volume(LAVp),left atrial ejection fraction(LAEF),left atrial passive ejection fraction(LAPEF),left atrial active ejection fraction(LAAEF).The parameters were standardized by body surface area(BSA).Results:1.Conventional parameters: There were no obvious differences between group B and group A(all P>0.05).Compared with groups A and B,LADs and peak A of group C were increased(both P<0.05),while peak E and E/A of group C were decreased(both P<0.05).2.The parameters of RT-3DE: There were no obvious differences between group B and group A(all P>0.05).Compared with groups A and B.LAVImax,LAVImin,LAVIp and LAAEF of group C increased significantly(all P<0.05),while LAPEF and LAEF decreased significantly(both P<0.05).Conclusion:RT-3DE could be an effective method to assess left atrial function in the patients with IDA.