Evaluation Of Left Atrial Function In Hypertensive Patients By Two-dimensional Speckle Tracking Imaging

Objective: To study the value of two-dimensional speckle tracking technology on the evaluation of left atrial mechanics function change in patients with hypertension,and to evaluate the correlation between left trial volume and left atrial strain.Methods: We selected 42 consecutive patients and 19 healthy volunteers in our hospital,and they were divided into three groups: left ventricular remodeling(LVH)(25 cases)? left ventricular with no remodeling(LVN)(17cases)and controlled group(19 cases).There were 61 cases(male 38,female 23)in the study aged from 36 to 83.Their average age was 61.0±11.2 years.Echocardiographic parameters including interventricular thickness(IVS),left ventricular diastolic dimension(LVDd),left ventricular systolic dimension(LVDs),left ventricular posterior wall thickness(LVPWd),regurgitative level of mitral and aotic valve,peak transmitral early(E)and late(A)velocities,early deceleration time(DT)by pulsed-wave Doppler and early(e')diastolic velocities by tissue-Doppler interrogation of the septal and lateral margins,thus E/A,LVEF,left ventricular mass(LVmass)were calculated.Hypertensive patients were divided into left ventricular remodeling(LVH)and left ventricular with no remodeling(LVN)according to recently published guideline.The LA LS analysis was obtained from the dedicated apical four-and two-chamber views(biplane analysis).LS curve included an initial negative deflection(LSneg),representing LA active contraction,followed by a positive deflection(LSpos)during LA filling.LSneg,LSpos,and their summation(LStot)values were recorded using the biplane approach by averaging individual values from 12 LA segments.Data were expressed as means ± SD.Continuous variables analyses were performed by one-way ANOVA and enumeration data analyses were expressed as percentage through chi-square analysis to calculate significance for comparisons between different treatments with the corresponding control.All statistics were performed with two-tailed test and the relationship among each variable was performed with Bivariate.All calculations were performed with SPSS Analysis Software(version 13.0,SPSS Inc.,Chicargo,IL,USA).Each experiment was repeated at least three times.For all analyses,the criterion for significance was P<0.05.Results: 1.Compared with controlled group,both systolic pressure in LVH(141.9±15.5mmHg VS 127.3 ±3.8 mmHg,P<0.05)and LVN(139.2±17.4 mmHg VS 127.3 ±3.8 mm Hg,P<0.05)showed deference that was of statistically significant.Two groups of hypertensive patients had no statistical difference both in systolic and diastolic pressure.Weight,height,age and the results of blood biochemical test had no difference among three groups(P>0.05).2.Compared with controlled group,IVS(11.5±0.9mm VS 9.4±0.7mm,P<0.05)and LVPW(11.2±1.0mm VS 8.9±0.8mm,P<0.05)were increased in LVH.LV mass(220.2±44.8g VS 176.3±31.1g,P<0.05)was also significantly increased in LVH.LV mass(220.2±44.8g VS 170.4±34g,P<0.05)increased in LVH compare with LVN.3.According to LA LS curve analysis,general LA LSpos decreased in LVH and LVN(p<0.05).4.Among routine LA function parameters,significant correlation with LALSpos was LA passive emptying volume index(r=0.374,p=0.015),significant correlation with LA LSneg was LA maximal volume index(r=0.495,p=0.001),and significant correlation with LALStot was E/e'(r=0.345,p=0.027).conclusions: The parameters of two-dimensional speckle tracking imaging can reflect the left atrial mechanical function and has correlation with the conventional echocardiographic parameters.Two-dimensional speckle tracking imaging can evaluate the changes of left atrial function early and accurately.