Study On Clinical Application Of Left Atrial Function And Left Ventricular Global Systolic Strain In Patients With HCM By Real-Time Three-Dimensional Echocardiography Combined With Three-Dimensional Speckle Tracking Imaging

Objective To comprehensively evaluate left atrial function and left ventricular global systolic strain characteristics in non-obstructive HCM patients with the change of left atrial size,and to analyze the correlation between left atrial volume and function parameters and left ventricular global systolic strain parameters in this study by the combined application of Real-time Three-dimensional echocardiography(RT-3DE)and Three-dimensional speckle tracking imaging(3D-STI).Methods A total of 85 patients diagnosed with HCM admitted to the General Hospital of Ningxia Medical University from October 2021 to December 2022 were included as the HCM group.According to left atrial maximum volume index(LAVImax-bip),the HCM group was divided into four groups.There were 30 patients with normal left atrial size(I group),22 patients with mild left atrial enlargement(II group),19 patients with moderate left atrial enlargement(III group),and 14 patients with severe left atrial enlargement(IV group),and 60 healthy volunteers matching the sex and age were selected as the control group.Obtaining left atrial and left ventricular relevant parameters of all subjects using Two-dimensional transthoracic echocardiography(2D-TTE),Real-time Three-dimensional echocardiography(RT-3DE)and Three-dimensional speckle tracking imaging(3D-STI).Firstly,the differences of the above parameters between the HCM group and the control group were compared,and then comparing the characteristics of the left atrial and the left ventricular three-dimensional parameters changes and analyzing the correlation between the left atrial volume and function parameters and the left ventricular global systolic strain parameters in the HCM group.Results Compared with the control group,LAVmax,LAVmin,LAVpre and LAVImax were significantly increased,and LATEF,LAPEF,LAAEF,LVGLS,LVGRS and LVGCS were significantly decreased in HCM group,the differences were statistically significant(P<0.01);The comparison of three-dimensional parameters among the subgroups(I,II,III,IV)in the HCM group,LAVmax,LAVmin,LAVpre and LAVImax showed an increasing trend and LATEF,LAPEF,LAAEF,LVGLS,LVGRS and LVGCS showed a decreasing trend with the increasing of left atrial volume,the differences were statistically significant(P<0.01);Correlation analysis showed that the absolute value of LVGLS was negatively correlated with LAVImax(r=-0.754,p<0.001),the LATEF,LAPEF and LAAEF are positively correlated with the absolute value of LVGLS(r=0.594,p<0.001;r=0.515,p<0.000;r=0.483,p<0.001).Conclusion 1.The left atrium was enlarged and it,s functiona was impaired,and the left ventricular systolic and diastolic functions were impaired in non-obstructive HCM patients.2.With the increasing of the left atrial volume,the left atrial function and the left ventricular global systolic strain function are significantly decreased during disease progression in non-obstructive HCM patients;3.When the left atrial maximal volume increases,left ventricular global longitudinal strain function decreases at the same time,and the decreasing of left ventricular global longitudinal strain is accompanied by the decline of the left atrial function.