Evaluation of left atrial function in patients with chronic congestive heart failure using strain/ strain rate imaging

Objective To evaluate the changes of left atrial (LA) structure and function in patients with chronic heart failure(CHF) using Strain/Strain Rate Imaging echocardiography (SRI). Methods Conventional echocardiography and tissue Doppler imaging were performed in 48 CHF patients and 41 healthy control subjects. Strain (S), time to peak strain (TS), peak systolic strain rate (SSR), peak early diastolic strain rate (ESR) and peak late diastolic strain rate (ASR) values were compared between the 2 groups and used to evaluate their LA function. Results Compared with the control group, left atrial diameter (LAD), left atrial diameter index (LADI), left atrial minimal volume (LAVmin), left atrial maximal volume (LAVmax), left atrial volume index (LAVI) and left atrial stroke volume(LASV) significantly increased in the CHF group(all P<0.05), while left atrial ejection fraction (LAEF) in the CHF group decreased significantly(P=0.02). Strain of Left atrial lateral wall(SLALW), strain of left atrial septum(SIAS), strain of left atrial inferior wall (SLAIW) and strain of left atrial posterior wall (SLAPW) were all decreased significantly in CHF patients but strain of left atrial anterior wall (SLAAW) when compared with the control group. In patients with CHF, SSR, ESR and ASR were significantly lower than those in controls(all P<0.05). Conclusions Left atrial reservoir function, booster pump function and conduit function decrease in CHF patients compared to those in normal individuals. SRI can quantitatively evaluate left atrial function in patients with CHF. Key words: Heart failure; Strain rate imaging; Left atrial function