Evaluation Of Left Atrial Structure And Function In Patients With Pre-hypertension By Real-time Three-dimensional Ultrasound And Speckle Tracking Imaging

Objective Real-time three-dimensional echocardiography(RT-3DE)and speckle tracking imaging(STI)were used to study the left atrial structure and function of pre-hypertension in adult males,and to explore its application value in the evaluation of left atrial function.Methods Sixty-two patients with pre-hypertension were divided into two groups according to the difference of blood pressure.The first stage group of hypertension(SBP 120-129 mm Hg and DBP <80mm Hg)was used in 31 cases,and the second stage group of hypertension(SBP 130-139 mm Hg and DBP 80-89 mm Hg)in 31 cases,and 35 adult males with ideal blood pressure(SBP <120mm Hg and DBP <80mm Hg)as a control group.Routine measurement of two-dimensional ultrasound parameters: Left atrial anteroposterior diameter(LAD),left ventricular end diastolic diameter(LVEDD),interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),early peak flow velocity of left ventricular diastolic in mitral valve anterior blood flow(E)and peak velocity of left atrial systole in anterior blood flow of mitral valve orifice(A),early peak velocity of left ventricular diastolic mitral annulus(E')and calculate the E/A value and E/E' value.The maximum left atrial volume(LAVmax),minimumleft atrial volume(LAVmin)and left atrial volume before contraction(LAVpre)were detected by using RT3 DE.The left atrial stroke volume(LASV),left atrial emptying fraction(LAEF%),left atrial passive ejection fraction(LAp%)and left atrial active ejection fraction(LAa%)were calculated;Strain values of different real phases of the left atrium were measured by STI: left atrial diastolic early strain rate(SRs),left atrial diastolic strain rate(SRe),and left ventricular diastolic strain rate(SRa),and calculate the average strain rates mSRs,mSRe,mSRa.Results(1)The results of two-dimensional echocardiographic parameters showed that the second-stage group of pre-hypertension had a thicker IVST than the first-stage group of pre-hypertension(P<0.05),and the difference of the remaining values was not statistically significant(P>0.05).In the second-stage group,the IVST and LVPWT were thicker than the ideal blood pressure group(P<0.05),and the difference of the remaining values was not statistically significant(P>0.05).There was no statistical difference between the first-stage group and the ideal blood pressure group.Academic significance(P>0.05).(2)Three-dimensional echocardiographic parameters showed that LAVmax,LAVpre,LASV,LAEF%,LAa% increased and LAp% decreased(P<0.05)when compared with the ideal blood pressure group and the first-stage pre-hypertension group.There was no significant difference in LAVmin(P>0.05).Compared with the ideal blood pressure group,the LAa% of the first-stage pre-hypertension group increased(P<0.05),and the differences of LAVmax,LAVpre,LASV,LAVmin,LAEF% and LAp% were not statistically significant(P>0.05).(3)Compared with the ideal blood pressure group and the first-stage pre-hypertension group,the mSRa increased and the mSRs and mSRe decreased in the second-stage pre-hypertension group(P<0.05);Compared with the ideal blood pressure group,mSRa increased(P<0.05),and there was no significant difference in mSRs and mSRe between the first-stage pre-hypertension group and the ideal blood pressure group(P>0.05).Conclusions RT-3DE and STI can detect early changes in the function and structure of early left atrium in patients with pre-hypertension,and can be used as a method to evaluate left atrial function in patients with pre-hypertension.