Evaluation Of The Left Atrial Function In Simple Overweight And Obese Adults By Two-dimensional Speckle Tracking Imaging

Objective:The purpose of this study was to use two-dimensional speckle tracking imaging technology to evaluate the changes of the left atrial segment function in simple overweight and obese adults,to obtain relevant and valuable information,in order to find out the situation of the left atrial segment function changed before the change of left ventricular function,providing the evidence for clinical diagnosis and treatment,guiding the overweight and obese people to take appropriate interventions measures to carry out health management in due time.Methods:In Yijishan hospital from October 2016 to December 2017,selected inpatient and outpatient health examination for simple overweight,obese adults(overweight:24?BMI<28,obese BMI?28)and healthy adults of normal weight(18.5?BMI<24)a total of 85 cases(including 32 cases of overweight and obesity in 22 cases,31 cases of normal weight)as the research objects.The research objects were confirmed not suffering from any heart related diseases,such as congenital heart disease,valvular heart disease,cardiomyopathy,coronary heart disease and secondary heart disease,and were excluded from chronic diseases which had obvious adverse effects on the heart,such as rheumatism,systemic lupus erythematosus,hypertension,diabetes,hyperthyroidism,uremia and so on.The heart rate,blood pressure,blood glucose,blood lipid,smoking,drinking,disease history and so on were obtained through careful inquiry,measurement and hospital HIS system.The height and weight of the subjects were measured strictly,and their BMI values were accurately obtained by calculation.The parameters reflecting the function of left atrium and left ventricle were measured and calculated by routine and pulsed or tissue Doppler ultrasound,such as left atrial minimum volume,left atrial maximum volume,left atrial p volume,calculating left atrial total ejection fraction,left atrial passive ejection fraction,left atrial active ejection fraction,left ventricular ejection fraction(m and Simpson's method),mitral orifice early diastolic peak velocities(V_E)and late diastolic peak velocities(V_A),isovolumic contraction time,isovolumic diastolic time and ventricular ejection time were measured by pulse Doppler and calculating V_E/V_A and myocardial performance index;measured the early diastolic peak velocity(Sep.e')and lateral wall point diastolic peak velocities(Lat.e')of mitral annular by tissue Doppler,and calculating V_E/Sep.e'and V_E/Lat.e'.The parameters related to the left atrial segmental function were measured by the 2D-STI technique,such as the strain rate of the basal section,middle section and the roof section of left atrial septum wall,lateral wall,inferior wall,anterior wall and posterior wall respectively in ventricular late diastolic and systolic and early diastolic period(SRa,SRs,SRe).The data collected above are recorded in detail and analyzed by statistical methods.Results:(1)In this study,there was no statistically significant difference in gender,age,heart rate,systolic blood pressure,diastolic blood pressure and plasma total cholesterol and blood glucose among the three groups(P>0.05).(2)There were no statistically significant difference in the indicators of left ventricular function:LVEF(M),LVEF(Simpson's),MPI,V_E/V_A,V_E/Sep.e'and V_E/Late among the three groups(P>0.05).(3)The routine measurement of indicators of left atrial ejection fraction:LATEF,LAAEF and LAPEF,there was statistically significant difference in LAPEF among the three groups(P<0.05),LATEF and LAAEF had no statistically significant difference(P>0.05).The comparison between the two groups in,There was statistically significant difference in LAPEF between two groups LAPEF,there was statistically significant difference between normal weight group and overweight group or obesity group(P<0.05),but there was no statistically significant difference between overweight group and obesity group(P>0.05).(4)The index of segmental function of the left atrial measured by 2D-STI technique was only mSRe of septum wall,lateral wall(basal section and the roof section)had statistically significant difference among the three groups(P<0.05),and the strain rate of the normal weight group,overweight group and obesity group decreased gradually,there was no statistically significant difference among the other indexes.The comparison between the normal weight and o-verweight group of the left atrial septal and lateral wall of the roof section of the mSRe,the normal weight group and obesity group of the left atrial septal and lateral wall(basal segment and the roof section)of the mSRe,the difference was statistically significant(P<0.05);the overweight group and obesity group parameters showed no statistically significant difference.(P>0.05).Conclusion:(1)The left atrial segmental function of the simple overweight and obese adults can be damaged before the change of left ventricular function,the first damage is the left atrial function of the pipe.(2)Using 2D-STI technology to observe the changes of strain rate of myocardium,it can effectively evaluate the changes of left atrial segmental function in the simple overweight and obese adults,and provide quantitative indicators for the change of left atrial function in the simple overweight and obese adults before the change of left ventricular function.(3)As a new ultrasonic technology,2D-STI technology can provide a new method and train of thought for detecting the change of left atrial segmental function in the simple overweight and obese adults.