الفهرس 
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Abstract
The left atrium (LA) plays an important role in the development of many heart diseases, and its size and function are closely correlated with various cardiovascular events. The mitral valve ring moves downward during left ventricular (LV) systole, and the LA is directly affected by LV pressure during the entire diastole. LV systolic and diastolic functions are both impaired in patients with ischemic dilated cardiomyopathy (IDCM) and non-ischemic dilated cardiomyopathy (NIDCM). The reservoir function of the LA is impaired because the mitral valve ring is not completely downcast during systole, and the LA contraction capacity can also be affected by LV diastolic dysfunction. Therefore, the clinical relevance of LA function is increasingly acknowledged. Two-dimensional speckle-tracking imaging (2DSTI) can quantify myocardial strain and strain rate during each cardiac cycle by tracking the movement of echo patterns on B- mode images and can be used to evaluate myocardial function. In the present study, we use 2DSTI to evaluate the LA strain and strain rates in patients with NIDCM and IDCM.
Aim of the work:
To assess Left Atrial Function in Patients with Ischaemic and Non-Ischaemic Dilated Cardiomyopathic Using Speckle Tracking Echocardiography.
Patients and methods:
Patients
This case-control study was conducted on 67 randomly selected individuals who presented to cardiology department of faculty of medicine, Menoufia University, Egypt, during the period of 8 months from January 2017 to October 2017.They included 52 patients with systolic HF, EF less than 50%, and the New York Heart Association (NHYA) ranging from class II to IV (patient group), and 15 normal individuals (control group) comprising 10 males (66.6%) and 5 females (33.3%). Among the 52 heart failure patients, 27 were diagnosed with ICM (ICM group), comprising 19 males (70.37 %) and 8 females (29.63%). The remaining 25 patients were diagnosed with DCM (DCM group), comprising 15 males (60 %) and 10 females (40%). Written informed consent was obtained from all patients and subjects. All work was performed with the approval of the Menoufia ethics committee.
All of the following conditions were excluded:
1.Any rhythm other than a normal sinus rhythm
2. Patients with significant valvular lesions
3. Congenital heart disease.
4. Patients with recent acute coronary syndrome in the least 6 months.
5. Patients with a poor echogenic window such as obese patients or patients with chronic obstructive pulmonary disease (COPD).
6. Patients with renal or liver cell failure.
Methods:
Our patients were subjected to the following:
1. Complete history taking
2. Detailed clinical examination
3. 12 lead surface electrocardiogram (ECG)
4. Transthoracic echocardiogram (TTE)
M-mode
2D mode
Doppler study
TDI
Volumetric assessment of left atrial function
2D speckle tracking echocardiography of left atrium & left ventricle
Results:
Results showed significant statistical changes as regards the following parameters between the study groups:
a) Basic Echocardiographic Parameters
b) Left Atrial Volume and Function Indexes
c) Left Atrial Strain and Strain Rate
Results also showed that the major findings were as follow:
1. The systolic and late diastolic strains and strain rates were lower in NIDCM and IDCM patients than in controls
2. Although there were no significant differences in basic echocardiographic features between NIDCM and IDCM patients, all of the systolic and late diastolic strains and strain rates were significantly lower in NIDCM than in IDCM patients
3. Among all strains and strain rates, Ss, SRs & Sa was positively correlated with AEI&LAAEF