Preliminary Study Of Changes Of Left Atirum In Hypertensive Patients With Real-time Three-dimensional Echocardiography

Objective: To observe the changes in left atrium function of storage,auxiliary pump, conduit and the left ventricular diastolic function before andafter left ventricular reconstruction caused by essential hypertension, with thereal-time three-dimensional echocardiography.Methods:45subjects with essential hypertension were divided into twogroups with the left ventricular mass index (LVMI), the left ventricularnon-hypertrophy group and the left ventricular hypertrophy group.28healthysubjects were observed as controlled group. The groups above were excludedabnormal heart rhythms as atrium fibrillation, a variety of valvular heart disease,cardiomyopathy, congenital heart disease and various factors of secondaryhypertension. Measured dates bellow by the routine ultrasound examination:left atrial anteroposterior diameter (LAD),diastolic interventricular septalthickness (IVSd), end-diastolic left ventricular diameter (LVEDd), diastolic leftventricular posterior wall thickness (LVPWd), left ventricular ejection fraction(LVEF), mitral flow spectrum of peak E (E),A peak (A), tissue doppler imagingof anterior mitral valve leaflet (Tissues Doppler Imaging, TDI) parameter E ’,system-generated E/E’. With the real time three-dimensional echocardiography(RT-3DE) gathered full volume images of all subjects in standard apical fourchamber view, connected synchronization ECG, introduced into Qlab6.0workstation and measured of left atrial volume (LAVmax), left atrial minimalvolume (LAVmin), pre-construction left atrial volume (LAVpre),to say inother word left atrium volume of the P wave corresponds to, and calculate theemptying volume of left atrial active contraction the (LAaV), left atrial totalemptying volume, namely, storage volume (LAtV), left atrial conduit volume (LAcV), left atrial total emptying fraction (LAEF). All analyses wereperformed with SPSS17.0, and p <0.05were considered statisticallysignificant.Results: LAD、LAVmax、LAVmin、LAVper、LAtV、LAaV and LAEFin the case group were higher (p <0.05), LAcV was lower than the controlgroup (p <0.05). The LAEF other non-LVH group were higher than the LVHgroup, but the LAcV was lower (p <0.05). Increase of the peak A and E/E ’ ofthe case group compared with the control group; between the three groups,peak E has non-significant difference (p>0.05).Conclusion: The changes in left atrium volume index in patients withhypertension confirmed that storage capabilities of the left atrium wasincreased, left atrium volume has changed before the remodeling of leftventricular, so it can be used to suggest the early heart damage of patients withhypertension. The auxiliary pump function of left atrium increased in the earlystage of hypertension, then left atrial ejection fraction decreased with leftventricular remodeling, and the auxiliary pump function was graduallydecompensate. The channel function reduced with the increasing ofhypertension. In the evaluation of left ventricular diastolic function, peak A wasmore stabilizer than peak E, especially the ratio of E/E ’ was more suitable forevaluation of left ventricular diastolic function.