Evaluation Of Left Atrial Function In Non-alchoholic Cirrhosis Patients Using Real-time Three-dimensional Echocardiography And Speckle Tracking Imaging

Objective To evaluate changes of left atrial(LA)structure and function in non-alchoholic cirrhosis patients using real-time three-dimensional echocardiography(RT-3DE)and two dimensional speckle tracking(2D-ST)imaging.Methods Totally 60 cirrhosis patients which were divided into Child-Pugh A,B and C groups according to hepatic function and 16 healthy volunteers were enrolled.RT-3DE was used to obtain LA diameters(LAD),maximum volume(LAVmax),pre-contraction volume(LAVpre),and minimum volume(LAVmin).LA total emptying fraction(LATEF),expansion index(LAEI),active emptying fraction(LAAEF)and passive emptying fraction(LAPEF)were calculated.2D-ST imaging was used to measure mean peak longitudinal strain of LA in systolic,early-diastolic,end-diastolic phase(mSs、mSe、mSa)and strain rate of systolicm(mSRs、mSRe、mSRa),LA stiffness(LAst)were calculated.Results Compared with control group,Child-Pugh A,B and C groups showed increased LAD,LAVmax,LAVpre,LAVmin and Last(all P<0.05).Child-Pugh B and C groups showed decreased LAPEF,mSe and mSRe(all P<0.05).Child-Pugh A and B groups showed increased LATEF,LAEI,mSs,mSRs,LAAEF,mSa,mSRa(all P<0.05).Child-Pugh C group showed increased LATEF,LAEI,LAAEF and decreased mSs,mSRs(both P<0.05).LASt had negative correlation with LAEI,mSs,mSRs,LAPEF,mSe and mSRe,and had no correlation with LATEF,LAAEF,LAVmax,LAVpre and LAVmin,mSa and mSRa.Conclusion The dysfunction of LA varies with liver function in non-alcoholic cirrhosis patients.RT-3DE and 2D-ST imaging can detect and evaluate dysfunction of LA in early stage.