Abstract:Objective To explore clinical application value of 4-dimensional automatic left atrial quantification (4D LAQ) in early quantitative evaluation of left atrial volume and function in patients with hypertensive disorder of pregnancy (HDP). Methods A total of 100 patients with HDP admitted to Yubei District People"s Hospital, Chongqing, were enrolled as HDP group between April 2021 and April 2024. According to disease severity, they were divided into low-risk group (59 cases) and medium-high risk group (41 cases). A total of 50 healthy pregnant women undergoing prenatal examination during the same period were enrolled as control group. All underwent 4D LAQ examination at 28w of gestation. The general data, left atrial volume parameters and strain parameters of 4D LAQ were compared between HDP group and control group, and among patients with different severity of HDP. The evaluation value of 4D LAQ parameters for disease severity in HDP patients was analyzed by Logistic regression analysis, and evaluation value of left atrial volume parameters and strain parameters for disease severity was analyzed by receiver operating characteristic (ROC) curves. Results LAVmax, LAVmin, LAVpreA, LAVImax, LAEV, absolute values of LAScd and LAScd-c in HDP group were significantly higher than those in control group, while LAEF, LAEI, LApEF, LASr and LASr-c were significantly lower than those in control group (P<0.05). BMI, systolic blood pressure, diastolic blood pressure, LAVmax, LAVmin, LAVpreA, LAVImax, LAEV, absolute values of LAScd and LAScd-c in medium-high risk group were significantly higher than those in low-risk group, while LAEF, LAEI, LApEF, LASr and LASr-c were significantly lower than those in low-risk group (P<0.05). Logistic regression analysis showed that increased LAVImax, absolute value of LAScd-c and decreased LASr were of evaluation value for disease severity in HDP patients (P<0.05). AUC and sensitivity of LAVImax combined with LASr and absolute value of LAScd-c for evaluating disease severity were 0.901 and 90.24% (P<0.05). Conclusion 4D LAQ left atrial parameters can be applied in early quantitative evaluation of changes in left atrial volume and function in HDP patients. The application value of LAVImax, LASr and absolute value of LAScd-c is good in evaluating disease severity.