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Study on left atrial function in patients with essential hypertension based on four-dimensional echocardiography
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  • JUNRONG HONG,
  • Pingyang Zhang,
  • Mengyao Fei,
  • Lingling Wang
JUNRONG HONG
Nanjing City Hospital of Traditional Chinese Medicine
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Pingyang Zhang
Nanjing First Hospital

Corresponding Author:[email protected]

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Mengyao Fei
Nanjing First Hospital
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Lingling Wang
Nanjing First Hospital
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Abstract

Objective: Patient with essential Hypertension to be evaluated using four-dimensionalautomatic left atrial quantification (4DLAQ). Output test and estimate occurrence of essential hypertension (EH). Methods: Select 80 EH patients. EH group and 36 healthy patients as control group. Left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWT), early E wave velocity of mitral valve diastole / mitral valve ring Myocardial displacement velocity (E/e’), biplanar left ventricular ejection fraction (Biplan LVEF), left atrial minimum volume (LAVmin), lateral left atrial maximum volume (LAVmax), left atrial pre-presistole volume (LAVpreA), left atrial ejection fraction obtained by two-dimensional echocardiography ( LAEF), left atrial passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF), left atrial reservoir longitudinal strain (LASr), left atrial catheter longitudinal strain (LAScd), Left Atrial Systolic Longitudinal Strain (LASct), Left Atrial Reservoir Circular Strain (LASr_c), Left Atrial Catheter Circular Strain (LAScd_c), Left Atrial Systolic Circular Strain (LASct_c) from 4DLAQ. Binary Logistic regression was used to analyze the effect of 4DLAQ strain parameters on EH. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of the 4DLAQ strain parameters of the EH. Results: 1. Blood pressure of Systolic (SBP) and blood pressure of diastolic (DBP) in the EH group were higher than in the control group ( p=0.000, 0.000, respectively). 2.LAD, IVST, LVDD, LVPWT, E/e’, LAVmin, LAVmax, LAVpreA increased in EH group ( p=0.000,0.000,0.072,0.000.0.000, 0.001, 0.052, 0.004), while biplaneLVEF,LAEF,LAPEF,LAAEF,LASr,LAScd,LASct,LASr_c,LAScd_c,LASct_c decreased ( p=0.090,0.000,0.009,0.064,0.000,0.000,0.000,0.000,0.000,0.689,respectively).3.Bland-Altman’s film illustrates the relationship between relationship and audience consent.4. LASr and LAScd are independent risk factors for EH. Under curve ROC areaAUC (AUC= 0.925, 95% CI[0.879-0.971], sensitivity 80.00%, specificity 94.44%), and the cut-off value for estimating the EH of LASr is 20%. Area under the ROC curve AUC (AUC=0.878, 95% CI [0.818-0.939], sensitivity 76.25%, specificity 86.11%, and the critical value for estimating the EH of LAScd was -11%. Conclusion: The increase in diameter in left atrial EH patients is earlier than the deterioration in left ventricular systolic function. 4DLAQ can analyze left atrial myocardial function by left atrial volume index, longitudinal strain, and circumferential strain and detect left atrial changes in EH patients. LASr and LAScd had a better estimate of EH among which LASr had the best effect. It now makes up for the lack of research on the left atrium and has important clinical applications.