Assessing left atrial volume and function in dyslipidemia patients using three-dimensional speckle tracking imaging

As a cardiovascular risk factor, dyslipidemia can impair cardiac function in the early stage. Left atrial (LA) volume and function changes are sensitive indicators, but traditional ultrasound is difficult to detect early changes. Three-dimensional speckle tracking imaging (3D-STI) provides a new method for evaluating LA function by analyzing myocardial motion with high precision. In this study, 3D-STI was used to evaluate the early LA volume and function in patients with different dyslipidemia, in order to provide a basis for early clinical intervention.

A total of 102 patients with dyslipidemia treated at The Affiliated Hospital of Qingdao University were selected and divided into the high total cholesterol (TC) group, high triglyceride (TG) group, low high-density lipoprotein cholesterol (HDL-C) group, and mixed dyslipidemia group. Thirty healthy volunteers approximately matched for age and gender were selected as the control group. Subsequently, the LA volume indices including LA maximal volume index (LAVi_max), LA minimal volume index (LAVi_min), and LA presystolic volume index (LAVip), the LA function parameters including LA ejection fraction (LAEF), passive LA emptying fraction (pLAEF), and active LA emptying fraction (aLAEF), and the LA global strain parameters including global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) were obtained by 3D-STI for further analysis.

The differences in LAVi_max, LAVi_min, LAVip, LAEF, and pLAEF were statistically significant among groups (P<0.05), and the difference in aLAEF was not statistically significant (P>0.05). The differences in GLS, GCS, and GRS were statistically significant (P<0.05) among groups. The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for GLS, GRS, GCS, LAEF, and GLS-LAEF in identifying patients with dyslipidemia was 0.740, 0.725, 0.681, 0.787, and 0.796, respectively. GLS-LAEF had the highest value, with a maximum Youden index of 0.484, a sensitivity of 78.40%, and a specificity of 70.00%. 3D-STI measurements of LAVi_max and LAVi_min showed correlation with LAVi_max' and LAVi_min' results measured by the Simpson method (r=0.936, r=0.911, P<0.05). The 3D-STI parameters showed strong intra-observer and inter-observer agreement as per the Bland-Altman analysis.

LA volume and function are adversely affected by dyslipidemia, especially in patients with mixed dyslipidemia. 3D-STI effectively evaluates LA volume and function in patients with different types of dyslipidemia.