Assessment Of Left Atrial Function By Real-time Three-dimensional Speckle Tracking Imaging In Patients With Ischemic Mitral Regurgitation

Objective To evaluate left atrial(LA)function in ischemic mitral regurgitation patients by real-time three-dimensional speckle tracking imaging(RT3D-STI).Methods Patients with coronary disease were divided into coronary heart disease group(n=30)and ischemic mitral regurgitation group(n=58),including mild MR(n=20),moderate MR(n=20)and severe MR(n=18).30 healthy participants were also included.The left atrial diameter(LAD),left ventricular end-systolic dimension(LVIDs),left ventricular enddiastolic dimension(LVIDd),left ventricular ejection fraction(LVEF)and the early diastolic(E)and late diastolic(A)transmitral peak velocity were measured by conventional ultrasound.The early diastolic(Em)and late diastolic(Am)tissue velocity of mitral annulus were also collected.The global atrial longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS)and LA maximal,minimal and pre-systolic volume(LAVmax,LAVmin and LAVp),LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were measured by RT3D-STI.Measurement t w s xpr ss s m n st n r v t on x s t r t st o norm l ty r n s tw n two roups w r n lyz us n Stu nt's t t st,n r n s tw n mult-groups were assessed by analysis of variance.Correlations between strain parameters and LAEF were determined by Pearson correlation coefficients.All statistical analysis were performed with SPSS 17.0(SPSS,Chicago,USA).All statistical tests were two-sided,and P value<0.05 was considered statistically significant.Results(1)The LAEF,LVEF,LApEF in coronary heart disease group and ischemic mitral regurgitation group decrease against the control group(P<0.05),and the LApEF results are lower in ischemic mitral regurgitation group(P<0.05);(2)Compared with the control group,the global atrial peak strains in coronary heart disease group and ischemic mitral regurgitation group decrease observably(P<0.01),and through the comparison of the two experimental group,the parameters are lower in ischemic mitral regurgitation group(P<0.05);along with the severity of mitral regurgitation,GLS,GCS and GRS decline in different degrees.(3)The deformation abilities of left atrial wall(GLS,GCS,GRS)have a positive correlation with LAEF(coronary heart disease group r=-0.810,-0.760,0.851;ischemic mitral regurgitation group r=-0.680,-0.745,0.583;P<0.05).Conclusion RT3D-STI may play an important role in evaluating left atrial functions of ischemic mitral regurgitation patients by surveying the volume changing,computing the left atrial ejection fraction and tracing the myocardial motion.RT3D-STI does can provide more valuable reference for clinical diagnosis and treatment.