Evaluation Of Left Atrial Function In Patients With Mitral Stenosis By Three Dimensional Speckle Tracking Echocardiography

[Objective]:Mitral stenosis is the most common type of rheumatic heart disease.With the development of the disease,long-term compensation makes left atrial overload,and the structure and function of left atrial has changed in recent years,the new technology of three-dimensional speckle tracking has been able to measure many strain parameters such as longitudinal,circumferential,radial and area strains,which can accurately reflect the whole and local myocardial deformation.The purpose of this study is to investigate evaluation of left atrial function in patients with mitral stenosis by three dimensional speckle tracking echocardiography.[Methods]:Choose 40 Patients who were diagnosed moderate to severe mitral stenosis in our hospital and choose 25 healthy volunteers as control group,all participants’clinical,conventional two-dimensional ultrasound and 3D-STI parameters,analysis and process the data.3D-STI data mainly includes:①left atrial storage function parameters:LAVImax,LATEF;②left atrial conduit function index:LAVIp,LAPEF;③left atrial booster pump function index:LAVIa,LAAEF;④ radial peak strain of left atrial myocardia 16 segment(RPS),longitudinal peak strain(LPS)and the circumferential peak strain(CPS),area peak strain(APS);the left atrial global radial strain(GRPS),global longitudinal strain(GLPS);global circumferential strain(GCPS);global area strain(GAPS).Test the results by using Paired T test and gorrelation analysis for relevant indicators.Evaluate the clinical value of three-dimensional speckle tracking in the assessment of left atrial function in patients with mitral stenosis.[results]1.①:left atrial storage function:compared with the control group,LAVImax were significantly increased(P<0.05),LATEF were significantly reduced(P<0.05);②:left atrial conduit function index:compared with the control group,LAVIp and LAPEF were significantly reduced(P<0.05);③:left atrial booster pump function index:compared with the control group,LAVIa were increased(P>0.05),LAAEF were significantly reduced(P<0.05);2.Compared with the control group,most of the 16 segments of the left atrium were reduced in LPS,CPS and APS.The difference was statistically significant(P<0.05),and the change of RPS index was not statistically significant.3.compared with the control group,the GLPS,GRPS,GCPS and GAPS were all reduced,but the change of GRPS was not statistically significant,the rest were statistically significant(P<0.05).4.GRPS,GLPS,GCPS and GAPS were positively correlated with LAAEF,and the correlation coefficients were 0.507,0.349,0.561,0.618(P<0.05)。[conclusion]1.The characteristics of impaired left atrial myocardial function in patients with mitral stenosis:the ASP decreased in all segments,which is the most representative of the parameters;LSP and CSP in most segments reduce;the storage function of the left atrium,the function of the pipe and the function of the support pump were all lower than the normal heart;2.The characteristics of impaired left atrial systolic function in patients with mitral stenosis:GLSP,GCSP and GASP were all decreased,and all the global peak strain was positively correlated with the left atrial active ejection fraction,and the GASP correlation was the best;3.3.3D-STI can detect changes in left atrial structure and myocardial whole and local function in patients with mitral stenosis,and area strain can be used as a more comprehensive and accurate evaluation parameter;4.3D-STI is a safe,non-invasive and convenient examination method.Combined with ejection fraction and other parameters,it can reflect the change of left atrial myocardium accurately,and it can provide reference for studying the structure and function of left atrial.