Evaluation Of Left Atrial Function In Non-ST-segment Elevation Acute Coronary Syndrome By Three-dimensional Ultrasound And Speckle Tracking

Objective: To evaluate left atrial(LA)function in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)using real-time three-dimensional echocardiography(RT-3DE)and two-dimensional speckle tracking echocardiography(2D-STE).Methods: 39 patients with NSTE-ACS and 41 patients in the control group were enrolled.The patients were examined by echocardiography 1-2 hours before coronary angiography.The maximum volume of left atrium,minimum volume of left atrium and pre-systolic volume of left atrium(LAVmax,LAV min,LAVpre)were obtained.The active left atrial emptying volume,active left atrial emptying fraction(LAVa,LAVaEF),passive left atrial emptying volume and passive left atrial emptying fraction(LAVp,LAVpEF)were calculated,total left atrial emptying volume,total left atrial ejection fraction(LAVt,LAVtEF).Left atrial strain parameters were obtained by off-line analysis of two-dimensional images using EchoPAC software:Ss,Se,Sa.Results: The Ss,Se,LAVt,LAVtEF,LAVp and LAVpEF in the case group were all smaller than the control group(P<0.05),There was no statistically significant difference between the Sa,LAVa,and LAVaEF case groups and the control group.The ROC curve suggests that the area under the curve of Se is the largest.the highest sensitivity(97.44%)and specificity(68.29%)are obtained when the optimal cutoff point is 0.657.Conclusion: Non-ST-segment elevation acute coronary syndrome affects left atrial function,manifested by decreased reserve function and duct function.RT-3DE and 2D-STE techniques can be used to evaluate left atrial function in patients with non-ST-segment elevation ACS,and we speculate that left atrial strain parameter Se may be a good index for detecting NSTE-ACS.