Evaluation of left atrial global and regional functions in patients with myocardial infarction using real-time triplane echocardiography and triplane strain rate imaging

AIM:To evaluate the left atrial global and regional functions in patients with myocardial infarction (MI) using real-time triplane echocardiography (RT-3PE) and triplane strain rate imaging (triplane-SRI). METHODS: Thirty one MI patients with left ventricular ejection fraction (LVEF)≥50%(group A), 20 MI patients with LVEF<50%(group B) and 30 normal controls (group C) were examined by RT-3PE and triplane-SRI. Peak velocities of mitral annulus were measured during the phase of systole (Sa), the early phase of diastole (Ea) and the late phase of diastole (Aa) by tissue Doppler. The transmitral peak rapid filling velocity (E) and peak atrial filling velocity (A) were measured by pulse Doppler. Left atrium maximal volume (LAVmax), left atrium minimal volume (LAVmin), left atrium presystolic volume (LAVpre), left atrium total emptying fraction (LAVtEF), left atrium passive emptying fraction (LAVpEF) and left atrium active emptying fraction (LAVaEF) were measured using RT-3PE software. Mean systolic peak strain rate (MSRS), mean early diastolic peak strain rate (MSRE) and mean late diastolic peak strain rate (MSRA) of left atrial anterior, lateral, posterior, inferior and septum sites were measured with triplane-SRI software. RESULTS: Compared with those in group C, Sa, Ea and Aa in group A and B all decreased significantly (P<0.05). E decreased significantly (P<0.05), A increased significantly (P<0.05), and EA in group B. Compared with those in group C, LAVtEF, LAVpEF and LAVaEF in group B and LAVtEF and LAVpEF in group A all decreased significantly (P<0.05), whereas no significant difference in LAVaEF was found in group A (P>0.05). Compared with those in group C, MSRS, MSRE and MSRA in group B and MSRS and MSRE in group A decreased significantly (P<0.05), whereas no significant difference in MSRA of left atrial ateral, posterior and inferior was found in group A. CONCLUSION: RT-3PE and triplane-SRI can comprehensively evaluate left atrial global and regional functions and booster pump of left atrium reflects the degree of left ventricular dysfunction to some extent.