Evaluation of left atrial function using four-dimensional volume-strain
in end-stage renal disease patients with preserved left ventricular
ejection fraction
Abstract
Objective: The purpose of this study was to investigate
alterations in routine echocardiographic parameters and left atrial(LA)
strains in normal LA and large LA groups in end-stage renal
disease(ESRD) patients. Methods: Thirty-five age-matched
healthy individuals and 82 patients with ESRD, including 52 with LA
maximum volume index(LAVmax I)<34 ml/m2 (normal LA group)and 30 with
LAVmax I≥34 ml/m2 (large LA group), were enrolled. LA volumes and
longitudinal and circumferential strains were measured using
4-dimensional(D) volume-strain technology. Results: Left
ventricular(LV) wall thickness, the Left ventricular mass index(LVMI),
peak early diastolic trans-mitral flow velocity/average peak early
diastolic mitral annular velocity(E/ E’), and peak systolic
dispersion(PSD) were higher in normal LA and large LA group compared
with the control group. Mitral valve early diastolic velocity/mitral
valve late diastolic velocity(E/A), the early diastolic velocity at the
septal mitral annulus(E’ septal), the early diastolic velocity at the
lateral mitral annulus (E’ lateral), global longitudinal strain(GLS),
left atrial peak longitudinal strain of reservoir function (LASr) and
left atrial peak longitudinal strain of conduit function(LAScd) were
lower in normal LA and large LA group compared with the control group.
Left atrial peak circumferential strain of reservoir function(LASr-c)
and left atrial peak circumferential strain of contractile
function(LASct-c) were lower in the large LA group compared with the
control group. In ESRD patients, LASr-c and LASct-c showed a good
correlation with LAVmax I. Conclusions: This study showed that
LA longitudinal strains had decreased before LA enlargement. When LA
enlargement occurred, the circumferential strains decreased. This may
indicate that longitudinal strain changed earlier than circumferential
strain in ESRD patients.