Left heart function evaluation of patients with essential hypertension and paroxysmal atrial fibrillation by two-dimensional speckle tracking imaging combined with real-time three-dimensional ultrasound imaging

Abstract

Background: This study aims to assess the value of two-dimensional speckle tracking imaging (2D-STI) combined with real-time 3-dimensional echocardiography (RT-3DE) in evaluating left heart function in patients with combined ETH and PAF. Methods: A prospective study was designed, and the research period was from January 2017 to January 2020. A PAF observation group comprised of patients with ETH and PAF, a PAF control group of patients with ETH but without PAF, and a healthy volunteer group referred to as the healthy group, each comprised of 50 patients was established. All patients underwent routine ultrasound imaging examination using 2D-STI and RT-3DE. The interventricular septum thickness (IVST), left and right atrioventricular diameter (LAD), left ventricular posterior wall thickness (PWT), left ventricular ejection fraction (LVEF), the mean left atrium peak strain (mSs, mSe, mSa), strain rate (mSRs, mSRe, mSRa), the left ventricular mass (LVM), left ventricular mass index (LVMI), and left atrial total emptying volume (LATEV), the left atrial volume index (LAVI), left atrial total emptying fraction (LATEF), left atrium expansion index (LAEI), left atrium passive ejection fraction (LAPEF), and left atrial active ejection fraction (LAAEF) were calculated. Patients in the PAF observation group received telmisartan combined with rosuvastatin after diagnosis and 12-and 24-month-follow up visits were conducted. During these visits, 2D-STI combined with RT-3DE was used to evaluate cardiac function and each patient's blood pressure was monitored. Results: Patients in the PAF observation group had a significantly longer course of ETH than patients in the PAF control group (13.5±4.4 vs. 10.32±5.6, P=0.002). The comparison of routine 2D-STI and RT-3DE ultrasound indexes among the three groups also showed significant differences (P<0.01). During the 2-year follow-up period, the IVST, LAD, PWT, and LVEF of remaining patients significantly improved as treatment progressed (P<0.05). The LAVI, LATEF, and LAEI also improved significantly as the treatment progressed (P<0.05). After 12 months of treatment, the recurrence rate of atrial fibrillation was 16.33% (8/45) and after 24 months this was 34.21% (13/38).Conclusions: Cardiac function could be evaluated comprehensively by 2D-STI combined with RT-3DE in patients with ETH combined with PAF at initial diagnosis and follow-up. Ethical approvalAll procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the Clinical Ethics Committee of The Central Hospital of

Atrial Failure: Mechanisms, Diagnosis, and Potential Therapeutic Targets

“…LAVI max>34 mL/m2 is regarded by the European Society of Cardiology (ESC) as a sign of increased LA [53]. The parameters obtained by calculating the volume changes can also reflect the left atrial function, mainly including the left atrial enlargement index (LAEI), which reflects the storage function, and the Left Atrial Active Ejection Fraction (LAAEF) and Total Ejection Fraction (LATEF) reflecting the auxiliary pump function, the Left Atrial Passive Ejection Fraction (LAPEF), which reflects conduit function, and the Left Atrial Function Index (LAFI), which reflects the overall function of the left atrium [54]. Jiang et al combined 2D-STI with RT3DE to evaluate atrial remodeling and functional changes in patients with AF accompanied by essential hypertension.…”

“…Jiang et al combined 2D-STI with RT3DE to evaluate atrial remodeling and functional changes in patients with AF accompanied by essential hypertension. They found that LAVI, LAEI, and LATEF improved significantly with treatment [54]. Zhang et al used the RT3DE method to evaluate left atrial end-diastolic volume index (ILAEDV), End-Systolic Volume Index (ILAESV), and Left Atrial Ejection Fraction (LAEF) in 50 pairs of AF patients and healthy individuals, then compared it with Two-Dimensional Echocardiography (2DE).…”

Values of real-time three-dimensional left atrial-ventricular volumes in healthy adults

“…At present, our study only explored the changes of left atrial-ventricular volume by LA-LV V-LOOP in healthy adults. Previous studies have shown that the volume of left atrium and ventricle also has great diagnostic and predictive value for other heart diseases, such as hypertensive heart disease [24], sepsis cardiomyopathy [25], dilated cardiomyopathy[26], heart failure [27] and so on. Next, we plan to explore other heart diseases accordingly.…”

Values of new ultrasonic imaging methods for the diagnosis of apical Takotsubo syndrome

“…Real-time 3D echocardiography (RT-3DE) and speckle tracking imaging (STI) are new modalities that have recently been introduced into clinical practice (8). RT-3DE does not assume the chamber geometry, can visually display the cardiac space structure and ventricular wall motion, and can provide direct measurement of the cardiac capacity and function (9,10). STI can be used to quantify all aspects of myocardial strain related to myocardial deformation and contractile function by measuring the displacement between 2 different points in a myocardial segment (11).…”