Objective: Patient with essential Hypertension to be evaluated using four-dimensionalautomatic left atrial quantification (4DLAQ). Output test and estimate occurrence of essential hypertension (EH). Methods: Select 80 EH patients. EH group and 36 healthy patients as control group. Left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWT), early E wave velocity of mitral valve diastole / mitral valve ring Myocardial displacement velocity (E/e’), biplanar left ventricular ejection fraction (Biplan LVEF), left atrial minimum volume (LAVmin), lateral left atrial maximum volume (LAVmax), left atrial pre-presistole volume (LAVpreA), left atrial ejection fraction obtained by two-dimensional echocardiography ( LAEF), left atrial passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF), left atrial reservoir longitudinal strain (LASr), left atrial catheter longitudinal strain (LAScd), Left Atrial Systolic Longitudinal Strain (LASct), Left Atrial Reservoir Circular Strain (LASr_c), Left Atrial Catheter Circular Strain (LAScd_c), Left Atrial Systolic Circular Strain (LASct_c) from 4DLAQ. Binary Logistic regression was used to analyze the effect of 4DLAQ strain parameters on EH. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of the 4DLAQ strain parameters of the EH. Results: 1. Blood pressure of Systolic (SBP) and blood pressure of diastolic (DBP) in the EH group were higher than in the control group ( p=0.000, 0.000, respectively). 2.LAD, IVST, LVDD, LVPWT, E/e’, LAVmin, LAVmax, LAVpreA increased in EH group ( p=0.000,0.000,0.072,0.000.0.000, 0.001, 0.052, 0.004), while biplaneLVEF,LAEF,LAPEF,LAAEF,LASr,LAScd,LASct,LASr_c,LAScd_c,LASct_c decreased ( p=0.090,0.000,0.009,0.064,0.000,0.000,0.000,0.000,0.000,0.689,respectively).3.Bland-Altman’s film illustrates the relationship between relationship and audience consent.4. LASr and LAScd are independent risk factors for EH. Under curve ROC areaAUC (AUC= 0.925, 95% CI[0.879-0.971], sensitivity 80.00%, specificity 94.44%), and the cut-off value for estimating the EH of LASr is 20%. Area under the ROC curve AUC (AUC=0.878, 95% CI [0.818-0.939], sensitivity 76.25%, specificity 86.11%, and the critical value for estimating the EH of LAScd was -11%. Conclusion: The increase in diameter in left atrial EH patients is earlier than the deterioration in left ventricular systolic function. 4DLAQ can analyze left atrial myocardial function by left atrial volume index, longitudinal strain, and circumferential strain and detect left atrial changes in EH patients. LASr and LAScd had a better estimate of EH among which LASr had the best effect. It now makes up for the lack of research on the left atrium and has important clinical applications.

Objective: Echocardiography is a time and cost-effective imaging modality, providing evidence of myocardial ischemia by detecting the regional wall motion abnormalities (RWMA). However, quite a few coronary heart disease (CHD) patients do not present RWMA. The left atrium (LA) plays an irreplaceable role in determining the prognosis and risk stratification of cardiovascular disease including CHD. In this present study, we intend to explore the myocardial mechanics changes of LA mainly using four-dimensional (4D) LA quantitative volume-strain in CHD patients without RWMA at rest but were confirmed by coronary angiography (CAG) and to figure out several variables of the LA that could contribute to the identification of those patients. Methods: We prospectively enrolled 76 patients who underwent two-dimensional echocardiography (2DE), four-dimensional echocardiography (4DE), and CAG for suspected CHD but without echocardiographic visible RWMA at rest. Patients diagnosed with CHD by CAG were furtherly divided into three groups according to the extent of coronary stenosis accessed by Gensini score (GS) as the mild, moderate, and severe CHD group. Twenty-four subjects with negative CAG results served as the control group. LA end-systolic anteroposterior diameter (LAAPD) and biplane LV ejection fraction (Biplane LVEF) were measured by 2DE; LA maximum volume (LAVmax), LA minimum volume (LAVmin), LA volume at the onset of atrial contraction (LAVpreA), LAVmax index (LAVmaxI), LA ejection volume (LAEV), LA ejection fraction (LAEF)accompanied by LA longitudinal strain during reservoir phase (LASr), conduit phase (LAScd), contraction phase (LASct) and LA circumferential strain during reservoir phase (LASr_c), conduit phase (LAScd_c), contraction phase (LASct_c) were measured by 4DE automatically. We compared these parameters between groups, explored how they change and whether they are related to the CHD severity.Results: LAEF, LASr_c, and LASct_c was lower in CHD group compared with the control group (p = .031, .002, .004, respectively). Pearson correlation analysis showed that LASr, LASct, LASr_c, and LASct_c negatively correlated with the GS. Additionally, LASr of patients in the severe CHD group decreased significantly compared with those in the 758