Evaluation Of Left Atrial Function In Patients With Hypertension Using Real-time Three-dimensional Volume Imaging Combined With Two-dimensional Speckle Tracking Technology

Objective:Using real-time three-dimensional echocardiography(RT-3DE)and two-dimensional speckle tracking(2D-STI)to evaluate left atrial function in patients with primary hypertension and normal subjects.Methods:According to the inclusion criteria and exclusion criteria,68 patients in the primary hypertension group and 35 patients in the normal control group were collected.The general information was collected first.All subjects were subjected to cardiac color Doppler ultrasound measurement by two-dimensional echocardiography.The measurement parameters included:Anterior and posterior diameter(LAD),diastolic ventricular septal thickness(IVSd),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWd),mitral valve early diastolic blood flow velocity(E),mitral valve Late diastolic blood flow velocity(A),mirtal annular early diastolic tissue velocity(Em),mirtal annular late diastolic tissue velocity(Am).Real-time three-dimensional volumetric imaging was used to measure left atrial maximum volume(LAVmax),left atrial precontraction volume(LAVpre),left atrial minimum volume(LAVmin),and corrected left body atrial volume(BSA)to calculate the left atrial maximum volume index(LAVImax),left atrial precontraction volume index(LAVIpre),left atrial minimum volume index(LAVImin),and calculated left atrial stroke volume(LASV),left atrial ejection fraction(LAEF),left atrial active ejection fraction(LAAEF),left atrial passive ejection fraction(LAPEF).2D-STI was used to describe the strain and strain rate taking the strain corresponding to the starting point of R wave as the baseline of strain and strain curve,and the strain rate of the left atrial wall peaks in each cardiac cycle was measured,including the left ventricular systolic left atrial wall peak strain rate(SRs),left ventricular diastolic early left atrial wall peak strain rate(SRe)and left ventricular diastolic late left atrial wall peak strain rate(SRa),calculate the average,ie mSRs,mSRe,mSRa,response to the left atrium Strain rate.The basic data,routine ultrasound measurements,left atrial volume index and ejection fraction,left atrial mean peak strain rate,and correlation analysis between LAPEF and SRe,LAAEF and SRa,LAEF and SRs were compared between the hypertension group and the normal control group.Results:1.Systolic blood pressure(140.866±16.68mmHg)and diastolic blood pressure(85.95±10.26mmHg)in the primary hypertension group,and systolic blood pressure(127.31 ± 4.34mmHg)and diastolic blood pressure(76.93±8.31mmHg)in the control group.The differences in systolic blood pressure and diastolic blood pressure between the two groups were statistically significant(P<0.05).2.Primary hypertension group:LVDd(47.33±4.61mm),IVSd(10.46±1.38mm),LVPWd(9.04±1.35mm),LADd(34.48±3.94mm),E(7.13±1.67cm/s),A(8.32±2.48cm/s),Em(5.94±1.58cm/s),Am(10.33 ± 3.85cm/s),E/A(0.92 ± 3.1),Em/Am(7.95±1.71).Normal control group:LVDd(43.01±3.63mm),IVSd(9.24±1.45mm),LVPWd(7.55±1.16mm),LADd(28.38±4.01mm),E(8.25±1.67cm/s),A(6.64±2.14cm/s),Em(7.9812.41cm/s),Am(8.19±2.14cm/s),E/A(1.36±0.56),Em/Am(8.831 2.14),There were statistically significant differences in LADd,IVSd,LVPWd,A,Am,E,Em,E/A,Em/Am between the two groups(P<0.05).There was no significant difference in LVDd between the two groups(P>0.05).3.AVmax(46.87±5.24ml),LAVmin(19.80±3.45ml),LAVpre(29.9814.31ml),LAVImin(11.49±3.69ml/m),LAVIpre(17.39±5.32ml/m),LAVImax (23.59±5.32ml/m),LAPEF(34.95±9.18%),LAAEF(33.47±10.79%),LAEF(55.50±8.14%),LASV(21.46±5.45ml).LAVmax(43.58±5.87ml),LAVmin(18.92±2.05ml),LAVpre(27.54±2.64ml),LAVImin(9.44±2.93ml/m),LAVIpre(13.67±3.57ml/m),LAVImax(21.1 6+4.63ml/m),LAPEF(35.74±9.32%)S LAAEF(30.25±10.72%),LAEF(58.67±8.46%),LASV(17.89±8.25ml),The differences in LAVImax,LAVImin,LAVIpre,LASV,LAEF,LAAEF and LAPEF between the two groups were statistically significant(P<0.05).4.mSRs(2.17±0.98s-1),mSRa(-2.83±0.54s-1),mSRe(-2.54±0.66s-1)in the primary hypertension group and mSRs(-2.67±0.62s-1),mSRa(-2.42±0.5s-1),mSRe(-2.83±0.49s-1)in the control group.The differences of mSRs,mSRa and mSRe between the two groups were statistically significant(P<0.05).5.There was a positive correlation between mSRs and LAEF,mSRe and LAPEF,mSRa and LAAEF(r=0.402,0.56,0.573,respectively).P<0.01).Conclusion:1.When the inner diameter of the left ventricle is normal in patients with primary hypertension,the function of left atrium savings and pipeline are weakened,and the compensatory of auxiliary pump is enhanced,suggesting that the left atrium function has changed in patients with essential hypertension in the early stage.2.RT-3DE and 2D-STI can comprehensively evaluate the three functions of left atrial saving,pipeline and auxiliary pump from different perspectives,and reflect the configuration and function of the left atrium in an early,effective and accurate manner.3.RT-3DE and 2D-STI can be used to evaluate the changes of left atrial function in patients with essential hypertension,and provide a basis for clinical treatment and prognosis of patients.