持续性心房颤动患者射频消融术后左心房功能追踪及其与炎症的关联分析

Left atrial function tracking and relationship between it inflammation in patients with persistent atrial fibrillation after radiofrequency ablation

目的探讨持续性心房颤动(房颤)患者射频消融术后左房功能变化趋势及其与炎症的关系。方法选择2021年1月至2021年11月就诊于安徽医科大学附属阜阳人民医院心血管内科的80例持续性房颤患者,行血常规及常规超声检查和四维自动左心房定量分析技术(4D Auto LAQ)分析,获取心房收缩期前容积、左心房最大容积、左心房最大容积指数、左心房最小容积、左心房前后径、左心房射血分数、左房四维应变参数、白细胞总数(WBC)、超敏C反应蛋白(hs-CRP),分析左心房功能变化趋势及其与炎症指标的关系。结果左心房最大容积于术后呈逐渐下降趋势。左心房最大容积指数、左心房最小容积、左心房收缩期前容积、左心房前后径、左心房射血分数、左房四维应变参数在术后1周内较术前明显下降,随后缓慢增加,在术后1个月左右恢复至术前水平,在术后3个月时较术前明显改善。WBC、hs-CRP均在房颤射频消融术后在术后第7 d明显下降,在随后的随访各时间段内逐渐降至正常,且其变化与左房功能变化存在相关性。结论持续性房颤患者射频消融术后左房功能在1个月内存在短暂的恶化期,术后3个月较术前明显改善,且其变化与炎症因子存在相关性。

Objective To discuss the change tendency of left atrial function and relationship between it and inflammation in patients with persistent atrial fibrillation(PeAF)after radiofrequency ablation(RFA).Methods PeAF patients(n=80)were chosen from the Second Department of Cardiovascular Medicine in People’s Hospital of Fuyang City affiliated to Anhui Medical University from Jan.2021 to Nov.2021.The patients were given blood routine examinations,routine ultrasonographic examination and analysis of four-dimensional auto quantification of left ventricular volume(4D Auto LAQ)for collecting indexes of left atrial presystolic volume(LAVpreA),maximum volume of left atrium(LAVmax),maximum volume index of left atrium(LAVImax),minimum volume of left atrium(LAVmim),atrial anteroposterior diameter(LAAPD),left atrial ejection fraction(LAEF),four-dimensional strain parameters of left atrium,the total white blood cell count(WBC)and high sensitivity C-reactive protein(hs-CRP).The change tendency of left atrial function and relationship between it and inflammation indexes was analyzed.Results LAVmax showed a descending trend after the operation.Within 1 week after the operation,LAVImax,LAVmim,LAVpreA,LAAPD,LAEF and four-dimensional strain parameters of left atrium decreased significantly,increased gradually,and then recovered to preoperative level after 1 month.All these indexes were improved after the operation for 3 months.The level of the total WBC and hs-CRP decreased significantly after RFA for 7 d,and decreased to normal levels in different follow-up periods.These changes were correlated to changes of left atrial function.Conclusion There is a short deterioration period of left atrial function in PeAF patients within 1 month after RFA,then left atrial function is improved significantly after about 3 months,and these changes are correlated to the changes of inflammatory factors.