Li Bing, Chen Meihua, Huang Xuning
Department of Ultrasound Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
ESC Heart Fail. 2025 Apr;12(2):1316-1325. doi: 10.1002/ehf2.15146. Epub 2024 Oct 30.
This study aimed to evaluate the utility of left atrial volume and function in uraemic patients using four-dimensional automatic left atrial quantification (4D auto LAQ) technology.
Thirty-four undialysed uraemic patients (U-ND group), 60 dialysed uraemic patients (U-D group), and 32 healthy volunteers (N group) were enrolled in our current study. Conventional echocardiographic parameters were recorded, and left atrial volume and strain parameters were analysed to determine statistical differences among the three groups. The Pearson correlation coefficient was employed to assess the relationships between left atrial ejection fraction and left atrial strain parameters.
Compared to the N group, uraemic patients often displayed left atrial enlargement and left ventricular hypertrophy. Significant increases were noted in left atrial diameter, interventricular septum thickness, left ventricular posterior wall thickness, E/e', diastolic blood pressure, systolic blood pressure, left atrial minimum volume, left atrial maximum volume, left atrial pre-atrial contraction volume, left atrial emptying volume and left atrial maximum volume index (P < 0.05). Conversely, the e', E/A ratio and left atrial reservoir longitudinal strain were significantly decreased (P < 0.05). However, no statistically significant differences were observed in the aforementioned parameters between the U-ND and U-D groups. The absolute values of left atrial conduit longitudinal strain and left atrial conduit circumferential strain, as well as left atrial passive ejection fraction, were notably lower in the U-D group compared to the N and U-ND groups, with statistically significant differences identified among the three groups (P < 0.05).
Uraemic patients exhibit marked left atrial enlargement and left ventricular hypertrophy, coupled with altered atrial function, particularly ductal dysfunction in the U-D group. The 4D auto LAQ technology proves advantageous in detecting these alterations, offering a promising tool for thorough cardiac assessment in this patient cohort.
本研究旨在利用四维自动左心房定量（4D自动LAQ）技术评估尿毒症患者左心房容积和功能的效用。
本研究纳入了34例未透析的尿毒症患者（U-ND组）、60例透析的尿毒症患者（U-D组）和32例健康志愿者（N组）。记录常规超声心动图参数，并分析左心房容积和应变参数，以确定三组之间的统计学差异。采用Pearson相关系数评估左心房射血分数与左心房应变参数之间的关系。
与N组相比，尿毒症患者常表现为左心房扩大和左心室肥厚。左心房直径、室间隔厚度、左心室后壁厚度、E/e'、舒张压、收缩压、左心房最小容积、左心房最大容积、左心房房性早搏前容积、左心房排空容积和左心房最大容积指数显著增加（P<0.05）。相反，e'、E/A比值和左心房储存器纵向应变显著降低（P<0.05）。然而，U-ND组和U-D组之间在上述参数上未观察到统计学显著差异。与N组和U-ND组相比，U-D组的左心房管道纵向应变和左心房管道周向应变的绝对值以及左心房被动射血分数显著降低，三组之间存在统计学显著差异（P<0.05）。
尿毒症患者表现出明显的左心房扩大和左心室肥厚，同时心房功能改变，特别是U-D组的管道功能障碍。4D自动LAQ技术在检测这些改变方面具有优势，为该患者群体的全面心脏评估提供了一个有前景的工具。
