Evaluation of left atrial volumes with real time three dimentional echocardiography and left atrial functions with speckle tracking based strain modality in the patients with frequent ventricular premature complexes

Background:Premature ventricular contractions (PVC) may cause subclinical changes in left atrial (LA) structure and function. We aimed to explore LA remodelling, using real time three dimensional (3D) volume analysis and speckle tracking echocardiography (STE) in patients with PVC and preserved left ventricular (LV) systolic function. Methods and Results: We recruited 41 patients with PVC (45.74±3.34 years and 55 % male) and 20, age and sex matched healthy controls. Conventional echocardiographic parameters (LV dimensions, LV ejection fraction) were similar between the groups. LA diameter was significantly increased in patients (4.11±0.21 cm to 3.62±0.16 cm, p=0.0001). LA volumes during reservoir (RV), conduit (CV) and contractile phases (AV) were measured. LA global systolic strain (S), early diastolic (ESRd) and late diastolic strain rate (LSRd) were calculated. LA RV ( 41.3±2.67 to 30.9±4.67; p=0,0001), CV (21.48±1.61 to 18.50±2.78 ; p=0,0001), AV ( 11.78±1.61 to 9.35±2.27 ; p=0,0036) were increased in patients with PVC. LA S value (9.97±1.01 % to 33±2.71 % ,p=0,0001) , LA ESRd (1.67±0.32 s¯¹ to 2.22±0.64 s¯¹ ; p=0,01) and LA LSRd (2.48±0.2 s¯¹ to 3.1±0.2 s¯¹ ; p=0,001) were impaired in the study group. Conclusion: Frequent PVC is associated with LA anatomical and functional remodelling in patients with normal LV EF. Real time 3D volume and STE analysis are adjunctive methods to determine LA dysfunction in patients with frequent PVC.