基于超声四维左房定量分析技术评价原发性高血压左心室肥厚患者的左房功能

目的 基于超声四维左房定量分析(4DLAQ)技术评价原发性高血压(EH)左心室肥厚(LVH)患者的左房功能。方法 选择EH患者80例，根据LVH的新标准将患者分为LVH组无LVH(NLVH)组，同时选取36例健康体检者作为对照组，3组均采用二维超声心动图测量得到二维超声数据，采用4DLAQ技术测量及分析得到左房容积参数包括左房最小容积(LAV_min)、左房最大容积(LAV_max)、左房收缩前容积(LAVpre A)、左房整体射血分数(LAEF)；左房应变参数包括左房储备期长轴应变、左房管道期长轴应变、左房收缩期长轴应变、左房储备期环形应变、左房管道期环形应变、左房收缩期环形应变，比较3组二维和四维技术所得数据的差异。结果 3组收缩压及舒张压的差异有统计学意义(P<0.05)。3组左心房内径、双平面左室射血分数、室间隔厚度、左心室舒张末期内径、左心室后壁厚度、E/e’的差异均有统计学意义(P<0.05)。3组LAV_min、LAV_{pre A}、LAEF、左心房被动射血分数、左心房主动射血分数的...

Evaluation of left atrial function in essential hypertensive patients with left ventricular hypertrophy based on four-dimensional echocardiographic quantitative analysis

  Objective  To evaluate left atrial function in essential hypertensive (EH) patients with left ventricular hypertrophy (LVH) based on four-dimensional echocardiographic quantitative (4DLAQ).  Methods  Eighty EH patients were selected and divided into NLVH group and LVH group according to the new LVH standard. At the same time, 36 healthy subjects were selected as the control group. The participants in the three groups were measured by two-dimensional echocardiography, and the left atrial volume parameters were measured and analyzed by 4DLAQ technology, including left atrial minimum volume (LAV_min), left atrial maximum volume (LAV_max), left atrial pre systolic volume (LAV_preA) and left atrial global ejection fraction (LAEF). The left atrial strain parameters include left atrial reserve long axial strain, left atrial conduit long axial strain, left atrial systolic long axial strain, left atrial reserve circular strain, left atrial conduit circular strain and left atrial systolic circular strain. The differences between the two-dimensional and four-dimensional data of the three groups of participants were compared.  Results  There were significant differences in mean systolic blood pressure and mean diastolic blood pressure among the three groups (P < 0.05). There were significant differences in left atrial diameter, Biplane LVEF, interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular posterior wall thickness and E/e' among the three groups (P < 0.05). There was significant difference in LAV_min, LAV_preA, LAEF, left atrial passive ejection fraction and left atrial active ejection fraction among the three groups (P < 0.05), but there was no significant difference in LAV_max (P > 0.05). There were significant differences in left atrial strain parameters among the three groups (P < 0.05). The consistency between and within observers was good (ICC > 0.90).  Conclusion  The increase of left atrial diameter in EH patients is earlier than the impairment of left ventricular systolic function. With the progress of the disease, the left atrial volume increases, the storage function and pipeline function are damaged, and the blood pumping function increases when the blood pumping function is in NLVH. With the aggravation of LVH, the blood pumping function of the left atrium decreases. 4DLAQ can find subtle changes in the left atrial function of EH patients and supplement the technical weakness of the current left atrial research. Its strain parameters are more sensitive to evaluate the left atrial function. Among them, the circular strain is more advantageous than the longitudinal strain in indicating the left atrial conduit function.