Echocardiography
The GE–Vingmed Vivid 7 system (GE-Vingmed Ultrasound AS, Horten, Norway) echocardiography device was used for echocardiographic examinations. Additionally, 2D, M-mode, and Doppler examinations were performed based on the American Society of Echocardiography (ASE) recommendations, and the LVDD was graded (11,12,13).
2DSTE was performed using Echopac PC version 8 GE, and this was used off-line from previous recordings according to the ASE and European Association of Cardiovascular Imaging (EACVI) recommendations. The LA strain parameters were calculated both from apical two and four-chamber views, and the average values were calculated based on the following parameters: left atrial reservoir strain (LASr), left atrial conduit strain (LAScd), left atrial conduit strain (LAScd), and left atrial contraction strain (LASct) (14).
The following echocardiographic parameters were examined: left atrium diameter (LAd); EF and end diastolic volume (EDV) that were calculated using the bi-plane Simpson method; left atrial volume index (LAVI); RV fractional area change (RV-FAC %); tricuspid annular plane systolic excursion (TAPSE); estimated systolic pulmonary artery pressure (sPAP); ratio of early diastolic mitral inflow velocity (E) to arithmetical mean of early diastolic lateral (E/Em average) and septal tissue velocities (Em); left atrial total emptying fraction (LATEF); left atrial passive emptying fraction (LAPEF); left atrial active emptying fraction (LAAEF); and the PVR ,which is derived from the formula that used the ratio of tricuspid regurgitation velocity to the time velocity integral of the RV outflow tract systolic flow (15).