摘要目的:应用四维自动左心房定量分析（4D Auto LAQ）技术评价肥厚型心肌病（HCM）合并射血分数保留型心力衰竭（HFpEF）患者的左心房功能，并探讨HCM合并HFpEF患者的独立影响因素。方法:前瞻性选取2023年9月至2025年3月郑州大学第一附属医院收治的左心室射血分数（LVEF）≥50%的HCM患者100例，其中合并HFpEF组50例，无心力衰竭（HF）组50例。收集HCM患者一般临床资料和常规超声参数，并应用4D Auto LAQ技术获取左心房四维容积及应变参数，包括左心房最小容积（LAVmin）、左心房最大容积（LAVmax）、左心房最大容积指数（LAVImax）、左心房收缩前容积（LAVpreA）、左心房排空容积（LAEV）、左心房射血分数（LAEF）、左心房储备期纵向及圆周应变（LASr、LASr-c）、左心房管道期纵向及圆周应变（LAScd、LAScd-c）、左心房收缩期纵向及圆周应变（LASct、LASct-c）和左心房最小容积指数（LAVImin），比较两组间上述参数的差异。采用单因素、多因素Logistic回归分析法确定HCM合并HFpEF患者的独立影响因素。采用组内相关系数对4D Auto LAQ参数进行重复性检验。结果:与无HF组比较，HFpEF组LAVmin、LAVmax、LAVpreA、LAVImin、LAVImax增大，LAEF、LASr、LAScd、LASct、LASr-c、LAScd-c、LASct-c减小（均 P<0.05）。多因素Logistic回归分析显示，LASr是HCM合并HFpEF患者最强独立影响因素（ OR=0.255， P=0.003）。一致性检验显示，4D Auto LAQ各参数组内相关系数均>0.7，一致性较好。 结论:4D Auto LAQ 技术可用于评价HCM合并HFpEF患者的左心房功能，LASr是HCM合并HFpEF患者的最强独立影响因素。

abstractsObjective:To evaluate the left atrial function in patients with hypertrophic cardiomyopathy（HCM）combined with heart failure with preserved ejection fraction（HFpEF）using four-dimensional automated left atrial quantification（4D Auto LAQ）technology，and to investigate the independent factors affecting patients with HCM combined with HFpEF.Methods:One hundred HCM patients with left ventricular ejection fraction（LVEF）≥ 50% who were admitted to the First Affiliated Hospital of Zhengzhou University from September 2023 to March 2025 were prospectively selected. There were 50 cases in the HFpEF group and 50 cases in the non-HF group. The clinical data and conventional ultrasound parameters of HCM patients were collected. The 4D Auto LAQ technology was applied to obtain the four-dimensional volume and strain parameters of the left atrium，including the minimum left atrial volume（LAVmin），the maximum left atrial volume（LAVmax），the maximum left atrial volume index（LAVImax），the pre-atrial contraction volume（LAVpreA），the left atrial emptying volume（LAEV），the left atrial ejection fraction（LAEF），the longitudinal and circumferential strains in the left atrial reservoir period（LASr，LASr-c），the longitudinal and circumferential strains in the left atrial conduit period（LAScd，LAScd-c），the longitudinal and circumferential strains in the left atrial contraction period（LASct，LASct-c），and the minimum left atrial volume index（LAVImin）. The differences in the above parameters between the two groups were compared. Univariate and multivariate Logistic regression analyses were used to analyze the independent influencing factors in HCM patients with HFpEF. The intraclass correlation coefficient was used to test the repeatability of the 4D Auto LAQ parameters.Results:Compared with the non-HF group，LAVmin，LAVmax，LAVpreA，LAVImin，and LAVImax increased，while LAEF，LASr，LAScd，LASct，LASr-c，LAScd-c，and LASct-c decreased in the HFpEF group（all P<0.05）. Multivariate Logistic regression analysis showed that LASr was the strongest independent influencing factor in patients with HCM combined with HFpEF（ OR=0.255， P=0.003）. The consistency test showed that the intraclass correlation coefficients of each parameters of 4D Auto LAQ were all>0.7，the consistency was good. Conclusions:4D Auto LAQ technology can be used to evaluate left atrial function in patients with HCM combined with HFpEF，and LASr is the strongest independent influence factor in patients with HCM combined with HFpEF.