Evaluationofleft Atrial Function In Patients With Chronic Kidney Disease By Real-time Three-dime Nsional Echocardiography And Two-dimesional Spot Tracking Technique

Objective:Real-time three-dimensional echocardiography(RT-3DE)and two-dimensional spot tracking technique(2D-STI)were used to evaluate the structural and functional changes of the left atrium(LA)in patients with chronic kidneydisease(CKD),so as to provide a reliable ultrasound imaging basis for the assessment of early cardiovascular risk in patients with CKD.Methods:A total of 32 patients with CKD diagnosed in the department of nephrology of our hospital were selected as the CKD group,and another 32 patients who came to our hospital for physical examination were selected as the control group.Routine echocardiography and RT-3DE and 2D-STI examinations were performed on the two groups,and the required parameters were collected,and then the collected parameters were statistically analyzed.RT-3DE and 2DSTI parameters include: LA reserve function indicators: LA maximum volume(LAVmax),LA overall systolic mean peak strain(mSs)and strain rate(mSRs),LA total empty-out fraction(LATEF);LA pipeline function indicators: LA pre-contraction volume(LAVpre),LA overall early diatolic mean peak strain(mSe)and strain rate(mSRe),LA passive empaying score(LAPEF);function indexes of LA auxiliary pump: LA minimum volume(LAVmin),LA overall mean peak strain(mSa)and strain rate(mSRa)in late diastolic period,LA active empting fraction(LAAEF);LA stiffness(LASt);LA expansion index(LAEI).Results:In the CKD group,LAVmax,LAVpre,LAVmin and LASt increased significantly compared with the control group,and LAEI decreased significantly compared with the control group(P< 0.05).Reserve function: mSs,mSRs and LATEF in CKD group were reduced compared with those in control group(P< 0.05);pipeline function: mSe,mSRe and LAPEF of CKD group were decreased compared with that of control group(P< 0.05);pump function: mSa,mSRa and LAAEF in CKD group were reduced compared with those in control group(P< 0.05).LASt was negatively correlated with mSs,mSRs and LAVpre(all P< 0.05);LAAEF,LAEI,mSRe,LAVmax and LAVmin were positively correlated(all P< 0.05).There was no correlation with mSe,mSa,LATEF and LAPEF(all P> 0.05).Conclusion:LA volume of CKD patients increased significantly.Patients with CKD have decreased LA reserve function,pipeline function and pump function.In patients with CKD,LASt increased,while LAEI significantly decreased.LASt can be used as an important predictor of LA structure and function in CKD patients.RT-3DE combined with 2D-STI can effectively evaluate the changes of LA structure and function in patients with CKD.