Estimation of Left Atrial Function Using Four-Dimensional Auto
Left Atrial Quantify Echocardiography in Patients with End-Stage Renal
Disease
Li Zhao1,2,3, Xuan Su1,2, Lini
Xian1,2, Jian Chen1,3, Xiaolei
Song1, Qinghui Wang1,2,3*and
Yunchuan Ding1,2,3*
1 Department of Ultrasound, Yanan Hospital of Kunming
City, the Affiliated Hospital of Kunming Medical University, Kunming,
Yunnan Province, 650051, China
2 Clinical Research Center of Cardiovascular
Ultrasound, Yunnan Province, 650051, China
3 Yunnan Province Key Laboratory of Cardiovascular
Diseases, Kunming, Yunnan Province, 650051, China
*Address correspondence to:①Qinghui Wang, Department of Ultrasound,
Yanan Hospital of Kunming City, the Affiliated Hospital of Kunming
Medical University, Kunming, Yunnan Province, 650051, China, E-mail:
wqh962099@163.com.②Yunchuan
Ding, Department of Ultrasound, Yanan Hospital of Kunming City, the
Affiliated Hospital of Kunming Medical University, Kunming, Yunnan
Province, 650051, China, E-mail:
dd82109@163.com.
Funding information: Funds of Yunnan Province Science and Technology
Department, China, Grant/Award Number:2017NS331
Background: Cardiovascular impairment is an important
complication of end-stage renal disease (ESRD) undergoing hemodialysis
(HD) therapy. Left atrial (LA) deformation is closely related to left
ventricular (LV) filling pressure and dysfunction, but quantification of
LA dysfunction remains a challenge. The purpose of this study was to
evaluate the LA function in ESRD patients using four-dimensional(4D)
auto left atrial quantification(4D-LAQ).
Methods: Thirty-seven ESRD patients (aged 51.68±15.98 years;
43% male) on HD and 34 healthy individuals (aged 42.03±11.50 years;
38% male) were enrolled in the study. All participants underwent
conventional echocardiographic examinations and 4D-LAQ. The measurements
of LA dimension, volume, emptying fraction, and
longitudinal/circumferential strain parameters during triphasic were
obtained from the LV long axis and apical 4-chamber views, which were
taken offline using software (GE EchoPac 203).
Results: In patients with ESRD, LA dimension and volume were
higher than the healthy group, while the LASr (22.54±6.14 vs 33.74±5.07;
p<0.05), LAScd
(-12.54±5.83 vs -20.03±5.21;p<0.05), LASct (-10.00±4.93 vs
-13.56±5.17;p<0.05 ), LASr-c (28.00±6.61 vs
35.29±7.24;p<0.05), and LAScd-c (-13.27±5.58 vs
-18.47±8.65; p<0.05) were significantly lower. Furthermore, a
good positive correlation was observed between the LAEF, LASr, and
LAScd-c values and LV filling pressure, which reflect diastolic
dysfunction.
Conclusion: We demonstrated that the LA strain in dialysis
patients was impaired before the occurrence of LA dilation. LA strain is
more sensitive than traditional echocardiographic parameters, and LASr
and LAScd-c may be useful to detect early myocardial involvement.