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Updated: Mar 26, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
[Evaluation of left atrial function by three-dimensional speckle-tracking echocardiography in heart failure with
Junsong Liu1, Jing Wang1, Bo Zhang1
1Department of Cardiology, General Hospital of PLA, Beijing 100853, China.
Insights
Heart failure with preserved ejection fraction (HFpEF) patients show reduced left atrial (LA) function. Advanced echocardiography reveals impaired LA reservoir, conduit, and pump function, especially in those with enlarged atria.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Heart failure with preserved ejection fraction (HFpEF) is characterized by diastolic dysfunction.
- Left atrial (LA) function plays a crucial role in cardiac hemodynamics and can be impaired in HFpEF.
Purpose of the Study:
- To evaluate left atrial (LA) function changes in HFpEF patients using three-dimensional speckle-tracking echocardiography (3D-STE) and real-time three-dimensional echocardiography (RT3DE).
- To assess the correlation between LA volume and LA function parameters in HFpEF.
Main Methods:
- 43 HFpEF patients and 18 healthy controls were enrolled.
- Patients were categorized based on left atrial maximum volume index (LAVImax).
- 3D-STE derived LA strains (LSs%, LSa%) at basal, middle, and roof levels, along with RT3DE and Doppler parameters, were analyzed.
Main Results:
- 3D-STE demonstrated satisfactory reproducibility for LA strain measurements.
- HFpEF patients exhibited reduced LA filling and emptying deformation, particularly at the middle LA level.
- LA stiffness increased, while LA expansion index and passive ejection fraction decreased in HFpEF patients; active ejection fraction was also reduced in those with enlarged atria.
Conclusions:
- Combined 3D-STE and RT3DE effectively assess comprehensive LA function.
- Middle LA level strains are ideal parameters for evaluating LA function in HFpEF.
- HFpEF patients have significantly impaired LA reservoir, conduit, and pump function, correlating with left ventricular diastolic dysfunction and atrial enlargement.
Objective:
To evaluate left atrial function changes inheart failure with preserved ejection fraction (HFpEF) patients by three-dimensional speckle-tracking echocardiography (3D-STE) and Real time three-dimensional echocardiograph (RT3DE).
Methods:
43 HFpEF patients and a control group with 18 healthy subjectswere enrolled. According to left atrial max volume index (LAVImax), patients were grouped as A (LAVImax < 34 ml/m²) and B (LAVImax ≥ 34 ml/m(2)). 3D-STE deformative parameters, left atrial ventricular-systolic longitudinal peak strain (LSs%) and left atrial pre-contraction longitudinal peak strain (LSa%), from three levels (Basal, Middle and Roof) and global were measured. These parameters combined with RT3DE and Doppler parameters were analyzed between groups.
Results:
Reproducibilities of MLSs and MLSa were satisfactory (ICC > 0.8). In group A, LA filling and emptying deformation reduced mainly in middle level (compared to control group: MLSs (33 ± 6)% vs (45 ± 9)%, MLSa (12 ± 3)% vs (17 ± 5)%, P < 0.05), while in group B, deformation of basal and roof levels also reduced (compared to A and control group: BLSs (18 ± 7)% vs (25 ± 8)% vs (29 ± 8)%, RLSs (24 ± 9)% vs (28 ± 8)% vs (32 ± 10)%; compared to control group: BLSa (11 ± 5)% vs (14 ± 4)%, RLSa (12 ± 5)% vs (15 ± 5)%; all P < 0.05). LA stiffness increased while LA expansion index (LAEI%), LA passive ejection fraction (LAPEF%) decreased significantly in HFpEF patients, LA active ejection fraction (LAAEF%) of group B also decreased.
Conclusions:
3D-STE in combination with RT3DE enables the assessment of LA function effectively and comprehensively. 3D-STE strains of LA middle level were ideal parameters for LA function assessment. HFpEF patients have significantly reduced LA reservoir, conduit, pump function and left ventricular diastolic dysfunction, and these changes were more apparent in patients with LA enlarged significantly.
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