Three-dimensional Echocardiography Combined With Two-dimensional Strain Technique Was Used To Evaluate Left Atrial Function In Patients With Essential Hypertension Complicated With Paroxysmal Atrial Fibrillation

In this study,Real-time three-dimensional echocardiography(RT-3DE)combined with Two-dimensional strain imaging was applied.2D-STI)conducted a correlation study on left atrial function of patients with Essential hypertension(EH)complicated with Paroxysmal atrial fibrillation(PAF).It provides reference value for the late clinical evaluation of the abnormal structure and function of the left heart.100 patients with essential hypertension in the First Affiliated Hospital of Hebei North University from June 2021 to June 2022 were selected,There were 50 cases of essential hypertension with paroxysmal AF group(EH-PAF group),50 cases of simple essential hypertension group(EH group),and 50 healthy subjects in the same period as the control group.50 healthy subjects in the same period were the control group.All the enrolled patients underwent routine echocardiography to record left atrial diameter(LAD),ventricular septal thickness(IVST),left ventricular posterior wall thickness(PWT),left ventricular ejection fraction(LVEF),Left ventricular enddiastolic diameter(LVEDd),left ventricular mass(LVM),left ventricular mass index(LVMI),and RT-3DE to obtain left atrial maximum volume(LAVmax)and left atrial minimum volume,LAVmin),left atrial systolic volume(LAVp),body surface area integration to obtain their respective volume index(LAVImax,LAVImin,LAVIp),and then calculate left atrial active ejection fraction(LAAEF),passive ejection fraction(left atrial).passive ejection fraction(LAPEF)and left atrial total ejection fraction(LATEF),using 2D-STI to obtain early diastolic peak strain rate(SRe),late diastolic peak strain rate(SRa),and systolic peak strain rate(SRs),and their mean peak strain rates(m SRe,m SRa,m SRs)were calculated,The differences of the above indexes between RT-3DE and 2D-STI in the three groups were compared,and the correlation between RT-3DE and 2D-STI in the EH-PAF group was analyzed.The study found:(1)Compared with the control group,the EH group increased LAD,IVST,PWT,LVMI higher;Compared with the EH-PAF group,the LAD,IVST,PWT,LVMI were further increased.(2)Compared with the control group,LAVImax,LAVImin and LAVIp in EH group increased,m Ss,m Se,m SRs,m SRe,LATEF and LAPE F were reduced;(3)Compared with EH group,LAVImax,LAVImin a nd LAVIp in EH-PAF group were further increased[(42.05±17.09)vs.(33.85±18.43)、(30.75±21.52)vs.(17.89±10.47)、(33.49±11.05)vs.(23.93±10.14)],The absolute value of m Ss,m Se,m SRs,m SRe,and LATEF,LAPEF and LAAEF were further reduced[m Ss:(13.33±7.06)vs.(24.32±13.73);m Se:(3.93±3.41)vs.(8.77±6.17);m SRs:(2.94±0.63)v s.(3.32±0.47);m SRe:(-1.25±0.87)vs.(-3.35±4.72);LATEF:{[0.22(0.03,0.37)]vs.[0.37(0.09,0.70)]};LAPEF:{[0.05(0.01,0.11)]vs.[0.08(0.02,0.17)]};LAAEF:{[0.14(0.02,0.20)]vs.[0.31(0.13,0.55)]};m Sa and m SRa in EH-PAF group were lower than those in EH group [m Sa:(9.74±4.86)vs.(24.72±20.40);m SRa:(-2.51±2.67)vs.(-4.72±6.15)](P<0.05);(4)Compared with the control group,m Sa,m SRa absolute value and LAAEF in EH group were increased(P<0.05);(5)In the EH-PAF group,m Ss and m SRs were positively correlated with LATEF,m Sa,m SRa and LAAEF,m Se,m SRe and LAPEF(P<0.05).Based on the above research,we draw the following conclusions: The storage,duct and auxiliary pump functions of the left atrium in the patients with essential hypertension with paroxysmal atrial fibrillation weredecreased compared with those in the patients with essential hypertension and the control group,and the auxiliary pump functions in the patients with essential hypertension were increased compared with the control group.RT-3DE combined with 2D-STI can comprehensively and accurately evaluate left atrial function in patients with essential hypertension accompanied by paroxysmal atrial fibrillation,providing reference value for clinical treatment.