Assessment Of Atrial Structure And Function Changes In Hypertension Heart Disease By Echocardiography And Strain Rate Analyzing

ObjectiveTo explore the left and right atrial structure and functional changes in various hypertension classified by diastolic state in virtue of echocardiography and strain rate analyzing(1)To validate and compare these new indices of Strain and strain rate parameters,Left and right atrial area index,volume index in various hypertension classified by diastolic state.(2) To compare these new indices of Strain and Strain rate on the atrial septum,the left atrial area index,left atrial diameter and tissue velocity of mitral annular.(3) To compare these new indices of Strain and Strain rate on the interatrial septum,the right atrial area index,right atrial diameter and tissue velocity of tricuspid annulus.(4) To explore the relationship between Regional myocardial function of the septum and the double atrial structural remodeling in essential hypertensive(EH) patients.Methods30 healthy adults(Control Group,16 men,14 women) and 108 hypertensive patients (56 men,52 women),without other cardiac diseases and systemic disorders,were included in this study.The hypertensive patients are further divided into 4 groups based on diastolic function classification:Group A,hypertensive with normal diastolic function;Group B, hypertensive with mildly impaired diastolic function,Group C:a pseudonormal mitral inflow pattern,Group D:restrictive filling group;The echocardiographic examinations were performed with a GE Vivid7 scanner equipped.For data acquisition three complete cardiac cycles were collected and stored in a cine-loop format,pulsed Doppler Data,tissue Doppler Data,tissue velocity imaging(TDI) Data were acquired with the subjects at rest,lying in the lateral supine position.General parameters were measured:left atrial diameter(LAD),right atrial diameter, interventricular septum thickness,left ventricular posterior wall thickness,left ventricular end-diastolic volume(EDV),end systolic volume(ESV),stroke volume (SV),ejection fraction(LVEF),mitral tricuspid annular early diastole(E) and late diastole(A) inflow velocities,and the ratio(E/A),left ventricular isovolumic relaxation time(IVRT),left atrial area index and tissue velocity imaging and strain rate imaging parameters.Results1.No statistical difference was found in sex,age,weight,height and heart rate between hypertension group and control group(P＞0.05).2.It is similar that in left atrial area index and volume index,there was not significantly difference between normal control group and group A(P＞0.05),while the parameters of the two groups were significant difference(P＜0.05) with B,C,D groups;B,C,D group were higher than those other two groups.The above-mentioned parameters are more sensitive to abnormal in left atrial function than left atrial dimension index of the conventional evaluation indexes.3.Right atrial area index in C,D group was inclined to enlarge compared with normal control group and group A,significant differences was found(P＜0.05)。4.The values of srtain rate and strain in artial septum mid-inferior segment were significantly higher than those of mid-superior part.Though SRe in group A was inclined to decrease compared with control group,no difference was found(P＞0.05). In control group,group A and group B,SRa was inclined to increase,but no difference was found between normal control group and group A(P＞0.05).Group B were higher than Group A,significant differences was found(P＜0.05).SRe decreased successively gradually,the parameters of group A,group B and group C were significant difference(P＜0.05).While in group B,group C and group D,SRa was inclined to decrease,significant differences was found between group C and group B(P＜0.05). 5.Both Se and Sa decreased successively gradually,significant differences of Se was found between groups except between group B and C(P＞0.05).While,SRa increased successively gradually(P＞0.05).6.Sa,SRe of septum was positive correlative with left atrial area index(P＜0.05)。Conclusion1.The strain and strain rate of septum changed before left ventricular diastolic dysfunction,and the Sa,SRe were more stable,sensitive.Sa,SRe of septum was superior to E/A in evaluating left ventricular diastolic function in Hypertensive Patients.2.Strain and strain rate curve is a superior method for the assessment of regional myocardial function of atria septum directly and can assess the effect of hypertension on left atrial deformation and the artial founction.3.Hypertension also inevitably impact on the structure and function of right atria, but Beginning of the Restructuring about the structure and function is later than others. The results about the correlative between Sa,SRe of septal and right atrial area index were consistent with the reports.