Nemes Attila, Kormányos Árpád, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis Street 8, P.O. Box 427, H-6725 Szeged, Hungary.
Biomedicines. 2024 Nov 4;12(11):2515. doi: 10.3390/biomedicines12112515.
In systole, when the left ventricle (LV) twists, the left atrium (LA) behaves like a reservoir, having a special wall contractility pattern opposite to that of the LV wall. Accordingly, the objective of the present study was to investigate the associations between LV rotational mechanics and LA peak (reservoir) strains as assessed simultaneously by three-dimensional speckle-tracking echocardiography (3DSTE) under healthy conditions.
In the present study, 157 healthy adults (mean age: 33.2 ± 12.7 years, 73 men) were involved. Complete two-dimensional Doppler echocardiography with 3DSTE-derived data acquisition were performed in all cases. The 3DSTE-derived LV rotational and LA strain parameters were determined at a later date.
Global LA peak reservoir circumferential (22.7 ± 6.4% vs. 27.6 ± 6.8%, < 0.05) and area (57.8 ± 20.0% vs. 66.0 ± 22.7%, < 0.05) strains proved to be reduced in the case of the highest vs. lowest basal LV rotation; other LA peak reservoir strains were not associated with increasing basal LV rotation. Global LA peak radial strain was highest in the case of the lowest vs. highest apical LV rotation (-19.2 ± 9.4% vs. -13.0 ± 8.2%, < 0.05). Global LA peak reservoir 3D strain was lowest in the case of the highest vs. lowest apical LV rotation (-9.9 ± 6.8% vs. -5.0 ± 4.2%, < 0.05). Only apical LV rotation proved to be significantly reduced in the case of the highest vs. lowest global LA peak reservoir 3D strain (8.12 ± 3.23° vs. 10.50 ± 3.44°, < 0.05). Other global LA peak reservoir strains were not associated with basal and apical LV rotations.
In LV systole, LV rotational mechanics is associated with LA deformation represented by LA peak (reservoir) strains even in healthy circumstances. While basal LV rotation is associated with LA widening, apical LV rotation is associated with LA thinning, suggesting the close cooperation of the LV and LA in systole even in healthy adults.
在收缩期，当左心室（LV）扭转时，左心房（LA）起到储存库的作用，其壁的收缩模式与左心室壁相反。因此，本研究的目的是在健康状态下，通过三维斑点追踪超声心动图（3DSTE）同时评估左心室旋转力学与左心房峰值（储存库）应变之间的关联。
本研究纳入了157名健康成年人（平均年龄：33.2±12.7岁，男性73名）。所有病例均进行了完整的二维多普勒超声心动图检查及3DSTE数据采集。之后确定3DSTE得出的左心室旋转和左心房应变参数。
在基础左心室旋转最高与最低的情况下，整体左心房峰值储存库圆周应变（22.7±6.4%对27.6±6.8%，P<0.05）和面积应变（57.8±20.0%对66.0±22.7%，P<0.05）均降低；其他左心房峰值储存库应变与基础左心室旋转增加无关。在心尖左心室旋转最低与最高的情况下，整体左心房峰值径向应变最高（-19.2±9.4%对-13.0±8.2%，P<0.05）。在心尖左心室旋转最高与最低的情况下，整体左心房峰值储存库三维应变最低（-9.9±6.8%对-5.0±4.2%，P<0.05）。仅在心尖左心室旋转方面，在整体左心房峰值储存库三维应变最高与最低的情况下有显著降低（8.12±3.23°对10.50±3.44°，P<0.05）。其他整体左心房峰值储存库应变与基础和心尖左心室旋转无关。
在左心室收缩期，即使在健康状态下，左心室旋转力学也与以左心房峰值（储存库）应变表示的左心房变形相关。基础左心室旋转与左心房增宽相关，心尖左心室旋转与左心房变薄相关，这表明即使在健康成年人中，左心室和左心房在收缩期也密切协作。
