title: [Evaluation of left atrial function by three-dimensional speckle-tracking echocardiography in heart failure with preserved ejection fraction patients].
abstract: OBJECTIVE
  To evaluate left atrial function changes inheart failure with preserved ejection fraction (HFpEF) patients by three-dimensional speckle-tracking echocardiography (3D-STE) and Real time three-dimensional echocardiograph (RT3DE).
  
  
  METHODS
  43 HFpEF patients and a control group with 18 healthy subjectswere enrolled. According to left atrial max volume index (LAVImax), patients were grouped as A (LAVImax < 34 ml/m²) and B (LAVImax ≥ 34 ml/m(2)). 3D-STE deformative parameters, left atrial ventricular-systolic longitudinal peak strain (LSs%) and left atrial pre-contraction longitudinal peak strain (LSa%), from three levels (Basal, Middle and Roof) and global were measured. These parameters combined with RT3DE and Doppler parameters were analyzed between groups.
  
  
  RESULTS
  Reproducibilities of MLSs and MLSa were satisfactory (ICC > 0.8). In group A, LA filling and emptying deformation reduced mainly in middle level (compared to control group: MLSs (33 ± 6)% vs (45 ± 9)%, MLSa (12 ± 3)% vs (17 ± 5)%, P < 0.05), while in group B, deformation of basal and roof levels also reduced (compared to A and control group: BLSs (18 ± 7)% vs (25 ± 8)% vs (29 ± 8)%, RLSs (24 ± 9)% vs (28 ± 8)% vs (32 ± 10)%; compared to control group: BLSa (11 ± 5)% vs (14 ± 4)%, RLSa (12 ± 5)% vs (15 ± 5)%; all P < 0.05). LA stiffness increased while LA expansion index (LAEI%), LA passive ejection fraction (LAPEF%) decreased significantly in HFpEF patients, LA active ejection fraction (LAAEF%) of group B also decreased.
  
  
  CONCLUSIONS
  3D-STE in combination with RT3DE enables the assessment of LA function effectively and comprehensively. 3D-STE strains of LA middle level were ideal parameters for LA function assessment. HFpEF patients have significantly reduced LA reservoir, conduit, pump function and left ventricular diastolic dysfunction, and these changes were more apparent in patients with LA enlarged significantly.
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
authors.forename: Junsong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
authors.forename: Bohan
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Lü
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China; Email: 13701141929@163.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Cardiology, General Hospital of PLA, Beijing 100853, China; Email: 13910994856@163.com.
authors.forename: Guang
authors.initials: G
authors.lastname: Zhi
mesh_terms: D016279:Atrial Function, Left; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D006325:Heart Atria; D006333:Heart Failure; D006352:Heart Ventricles; D006801:Humans; D013599:Systole