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Updated: Jan 18, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Evaluation of Left Atrial Function in Patients with Hypertensive Heart Disease and Preserved Ejection Fraction Using
Insights
Real-time, three-dimensional speckle tracking imaging (RT-3D-STI) effectively assesses left atrial (LA) dysfunction in patients with hypertensive heart disease and heart failure with preserved ejection fraction (HFpEF). LA strain parameters, including LA strain during the reservoir phase (LASr), provide a non-invasive quantitative evaluation for this patient group.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertensive heart disease (HHD) and heart failure with preserved ejection fraction (HFpEF) significantly impact cardiac function, particularly left atrial (LA) function.
- Accurate assessment of LA dysfunction is crucial for managing patients with HHD and HFpEF.
- Traditional echocardiographic parameters may not fully capture the nuances of LA function in these conditions.
Purpose of the Study:
- To investigate the utility of real-time, three-dimensional speckle tracking imaging (RT-3D-STI) for evaluating left atrial (LA) function in patients with HHD and HFpEF.
- To compare LA function parameters between patients with HFpEF and healthy controls.
- To explore the diagnostic value of LA strain parameters for identifying HFpEF and their correlation with NT-proBNP levels.
Main Methods:
- A retrospective study involving 100 patients with HHD and HFpEF and 100 healthy controls.
- Standard echocardiography was performed to measure various cardiac dimensions and functional parameters.
- RT-3D-STI was utilized to analyze LA images and derive parameters such as LA emptying fraction (LAEF), LA strain during reservoir (LASr), contraction (LASct), and conduit (LAScd) phases.
Main Results:
- Patients with HFpEF exhibited significantly higher blood pressure and NT-proBNP levels compared to controls.
- While LVEF and other standard parameters showed no significant differences, HFpEF patients had increased LA diameter (LAD), interventricular septal thickness (IVST), and left ventricular posterior wall thickness (LVPWT).
- HFpEF patients demonstrated impaired LA function, characterized by lower e', LAEF, LASr, LAScd, and LASct, and higher LAVmax and E/e' ratios. LASr was negatively correlated with NT-proBNP.
Conclusions:
- RT-3D-STI provides valuable quantitative insights into LA dysfunction in patients with HFpEF.
- LA strain parameters, particularly LASr, serve as sensitive, non-invasive markers for assessing LA function in this population.
- These findings suggest RT-3D-STI can aid in the clinical management and risk stratification of patients with HFpEF.
Abstract:
Objective This research investigated the application of real-time, three-dimensional speckle tracking imaging (RT-3D-STI) to evaluate left atrial (LA) function in individuals suffering from hypertensive heart disease (HHD) and heart failure with preserved ejection fraction (HFpEF).Material and methods This retrospective study included 100 patients with HHD and HFpEF hospitalized from August 2023to June 2024 (HFpEF group). 100 healthy individuals undergoing physical examinations comprised the control group. Patient data were collected, and echocardiography was performed to measure LA diameter (LAD), left ventricular end diastolic diameter (LVEDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular outflow tract diameter (LVOTd), early diastolic maximum velocity of mitral valve inflow (MVE), late diastolic maximum velocity of mitral valve inflow (MVA), early diastolic and late diastolic velocities of mitral annulus measured by tissue Doppler ultrasound (e' and a'), tricuspid annular plane systolic excursion (TAPSE), and left ventricular ejection fraction (LVEF). The LA images were analyzed using GE software, and the following parameters were measured: L emptying fraction (LAEF), LA emptying volume (LAEV), LAvolume at the onset of contraction (LAVpreA), minimum LA volume (LAVmin), maximum LA volume (LAVmax), LA strain during the reservoir phase (LASr), LA strain during the contraction phase (LASct), and LA strain during the conduit phase (LAScd). ROC curves were adopted to evaluate the diagnostic value of LA parameters for HFpEF, and a Pearson correlation analysis examined the relationship between these parameters and N-terminal pro-B-type natriuretic peptide (NT-proBNP).Results Compared with the control group, the blood pressure in the HFpEF group was significantly higher (p<0.05). In the HFpEF group, NT-proBNP concentrations were significantly greater than those observed in the control group (p<0.05). No statistically significant variances were detected in LVEF, LVEDD, LVOTd, TAPSE, MVE, MVA, ratio of E wave velocity to A wave velocity (E / A), a', LAEV, LAVmin, or LAVpreA between the two groups (p>0.05). Compared to the control group, the HFpEF group had dramatically higher LAD, IVST, and LVPWT (p<0.05). The HFpEF group also had lower e', LAEF, LASr, LAScd, and LASct, while E / e', maximum LA volume index (LAV Imax), and LAVmax were higher (p<0.05). LASr was negatively associated with NT-proBNP (r=-0.255, p=0.016), whereas no significant correlation was found among LAScd, LASct, and NT-proBNP (P>0.05).Conclusion LA strain parameters can serve as a non-invasive method for quantitatively assessing LA dysfunction in patients with HFpEF.
