左心房扩张指数联合斑点追踪成像评价房颤射频消融术前及术后左心房功能

Evaluation of left atrial function before and after radiofrequency ablation of atrial fibrillation by left atrial dilation index combined with speckle tracking imaging

目的:应用左心房扩张指数(LAEI)联合三维斑点追踪成像(3D-STI)评价心房颤动(AF)患者射频消融术(RFCA)前后左心房功能。方法:选取2022年12月—2023年6月威海市中心医院RFCA治疗成功的31例阵发性AF患者(设为PAF组)、32例持续性AF患者(设为CAF组)及30例健康志愿者(设为对照组)为研究对象,均进行常规及三维超声心动图检查获得LAEI,应用3D-STI对三维图像进行分析获得左心房心肌整体纵向应变(GLS)、圆周应变(GCS),比较三组研究对象以及PAF组和CAF组术前与术后各参数差异,分析LAEI与GLS、GCS之间的相关性。结果:与对照组比较,术前PAF组和CAF组GLS、GCS、LAEI减低,差异有统计学意义(P<0.05)。与术前相比,术后PAF组和CAF组GLS、GCS、LAEI增加,差异有统计学意义(P<0.05)。LAEI与GLS、GCS呈显著负相关性(P<0.05)。结论:较健康志愿者,AF患者左心房功能已受损;RFCA术后,PAF和CAF患者左心房功能改善;LAEI、GLS、GCS能早期有效评价左心房功能的变化。

Objective To evaluate the changes in left atrial function before and after radiofrequency ablation(RFCA)in patients with atrial fibrillation(AF)by left atrial expansion index(LAEI)combined with three-dimensional speckle tracking imaging(3D-STI).Methods 31 patients with parsmal AF(set as PAF group),32 patients with persistent AF(set as CAF group)and 30 healthy volunteers(set as control group)who were successfully treated by RFCA in Weihai Central Hospital from December 2022 to June 2023 were selected as study objects.LAEI was obtained by routine and three-dimensional echocardiography.Three-dimensional images were analyzed with 3D-STI to obtain the global longitudinal strain(GLS)and circumferential strain(GCS)of the left atrial myocardia.Preoperative and postoperative parameter differences among the three groups,PAF group and CAF group were compared,and the correlation between LAEI and GLS and GCS was analyzed.Results Compared with the control group,GLS,GCS and LAEI in PAF and CAF groups were decreased before surgery,and the difference was statistically significant(P<0.05).GLS,GCS and LAEI in PAF and CAF groups were increased after surgery compared with those before surgery,and the difference was statistically significant(P<0.05).LAEI was significantly negatively correlated with GLS and GCS(P<0.05).Conclusion Compared with healthy volunteers,the left atrial function was already impaired in AF patients;After RFCA,the left atrial function of PAF and CAF patients improved;LAEI,GLS and GCS can effectively evaluate the changes of left atrial function in early stage.