Assessment of Left Atrial Function by Real-time Three-dimensional Speckle Tracking Imaging in Coronary Heart Disease with Mitral Regurgitation / 中国医学影像学杂志

ABSTRACT

Purpose To detect left atrial volume change and myocardial strain,and to evaluate left atrial (LA) function in coronary heart disease patients with mitral regurgitation (MR) by real-time three-dimensional speckle tracking imaging (RT3D-STI).Materials and Methods Eighty-eight patients with coronary disease were divided into non mitral regurgitation group (NMR group,n=30) and mitral regurgitation group (MR group,n=58),including mild MR (n=20),moderate MR (n=20) and severe MR (n=18).Thirty healthy participants were also included as control group.Using RT3D-STI,the global atrial longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),LA maximal,minimal and pre-systolic volume (LAVmax,LAVmin and LAVp),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF) were measured,and the relationship between LA myocardial strain and left ventricular function was analyzed.Results ① The LAEF,LVEF,LApEF in NMR group and MR group decreased compared those with the control group (P＜0.05),and the LApEF in MR group were lower than those in NMR group (P＜0.05);② compared with the control group,the GLS and GCS in NMR group and MR group decreased observably (P＜0.05),and the parameters in MR group was lower than those in NMR group (P＜0.05);along with the severity of mitral regurgitation,GLS,GCS and GRS declined in varying degrees.③ The overall strain ability of left atrial myocardium (GLS,GCS,GRS) had a positive correlation with LAEF (NMR groupr=-0.810,-0.760 and 0.851;MR groupr=-0.680,-0.745 and 0.583;P＜0.05).Conclusion RT3D-STI plays an important role in assessing LA myocardial movement change and evaluating left atrial function of mitral regurgitation patients by nvestigating left atrial volume change,calculating LAEF and tracing myocardial motion,which provides valuable references for clinical diagnosis and treatment.