Assessment of Left Atrial Function by 4D Auto Left Atrial Quantification Echocardiography for Differentiation of Pre-capillary and Post-capillary Pulmonary Hypertension
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0413
- VernacularTitle:4D Auto LAQ评估左房功能对鉴别毛细血管前、后PH的价值
- Author:
Cuiling LI
1
;
Xinli LEI
;
Fei XIAO
;
Rui FAN
;
Siying LIAO
;
Donghong LIU
;
Hong LIN
;
Fengjuan YAO
Author Information
1. 中山大学附属第一医院超声医学科//中山大学超声与介入诊断研究所,广东 广州 510080
- Publication Type:Journal Article
- Keywords:
echocardiography;
4D LAQ;
left atrial volume;
left atrial strain;
pulmonary to left atrial ratio
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(4):667-675
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To evaluate the utility of left atrial(LA)volume and strain measured by 4D auto left atrial quantification(4D auto LAQ)in differentiating pre-capillary from post-capillary pulmonary hypertension(PH),and to compare its discriminative performance with echocardiographic pulmonary to left atrial global strain ratio(ePLAGS).[Methods]A total of ninety-eight subjects with intermediate to high probability of PH were prospectively enrolled.Clinical history and laboratory data were collected.All patients underwent comprehensive transthoracic echocardiography,and LA volume and strain parameters were measured by dedicated commercial software for LA 4D analysis.[Results]Based on pulmonary arterial wedge pressure,patients were divided into pre-capillary PH group[n=39;mean age(53±24)years]and post-capillary PH group[n=59;mean age(57±18)years].Compared to the pre-capillary PH group,the post-capillary PH group showed significantly higher LAVImax,LAVImin and LAVIpreA but markedly lower LASr and LAScd.Multivariate logistic regression identified LAVImax[OR:1.40;95%CI:(1.052,1.872);P=0.021]and LAScd[OR:1.76;95%CI:(1.183,2.489);P=0.004]as independent predictors of post-capillary PH.ROC analysis demonstrated that LAVImax(AUC=0.82,P＜0.001)and LAScd(AUC=0.78,P＜0.001)had strong discriminating power for predicting post-capillary PH group,with optimal cutoff values of 35.69 mL/m2(sensitivity 86%,specificity 74%)and-9%(sensitivity 80%,specificity70%).[Conclusion]LAVImax and LAScd measured with 4D auto LAQ are robust parameters for distinguishing pre-capillary PH from post-capillary PH.
