左房应变参数联合左心耳排空速度预测持续性心房颤动消融术后早期复发的临床价值  

Clinical value of left atrial strain parameters combined with left atrial appendage emptying velocity in predicting early recurrence after persistent atrial fibrillation ablation

作　　者：时伟强 陆静[1] 李娜娜 燕爱迪 任永凤[1] SHI Weiqiang;LU Jing;LI Na’na;YAN Aidi;REN Yongfeng(Department of Ultrasound Medicine,Bozhou Hospital Affiliated to Anhui Medical University,Bozhou 236800,China;Department of Cardiovascular Medicine,Bozhou Hospital Affiliated to Anhui Medical University,Bozhou 236800,China)

机构地区：[1]安徽医科大学附属亳州医院超声医学科,安徽亳州236800 [2]安徽医科大学附属亳州医院心血管内科,安徽亳州236800

出　　处：《临床超声医学杂志》2025年第3期204-209,共6页Journal of Clinical Ultrasound in Medicine

基　　金：亳州市卫生健康科研重点项目(bzwj2023b010)。

摘　　要：目的探讨左房应变参数联合左心耳开口处排空速度(LAAeV)预测持续性心房颤动(PeAF)消融术后早期复发的临床价值。方法前瞻性选取于我院行导管消融术的PeAF患者122例,依据3个月随访结果分为复发组和未复发组。消融当日应用常规超声心动图获取左室舒张末期内径(LVEDD)、左房前后径(LAD)、左房容积指数(LAVI)、左房射血分数(LAEF)、左室射血分数(LVEF);脉冲多普勒获取二尖瓣口舒张早期峰值流速(E),组织多普勒获取室间隔及左室侧壁二尖瓣环舒张早期运动速度平均值(e’),计算E/e’;经食管超声心动图获取LAAeV;二维斑点追踪技术获取左室整体纵向应变(LVGLS)、左房储器期应变(LASr)、左房管道期应变(LAScd)、左房泵期应变(LASct),比较两组上述参数的差异。采用二元Logistic回归分析筛选预测PeAF消融术后早期复发的独立影响因素;绘制受试者工作特征(ROC)曲线分析各独立影响因素单独及联合应用预测PeAF消融术后早期复发的诊断效能。结果最终纳入74例PeAF患者,其中复发组26例,未复发组48例。两组LAD、LAVI、LAAeV、LVGLS、LASr、LASct比较差异均有统计学意义(均P<0.05),LVEDD、LAEF、LVEF、E/e’及LAScd比较差异均无统计学意义。二元Logistic回归分析显示,LAAeV、LASr、LASct均为预测PeAF消融术后早期复发的独立危险因素(OR=1.789、2.290、1.204,均P<0.05),由此建立回归方程为:Logit(P)=-13.587+0.548×LASr+0.846×LASct+0.296×LAAeV。ROC曲线分析显示,LAAeV、LASr、LASct预测PeAF消融术后早期复发的曲线下面积分别为0.839、0.821、0.709,三者联合应用的曲线下面积为0.938,高于各参数单独应用,差异均有统计学意义(均P<0.001)。结论左房应变参数联合LAAeV在预测PeAF消融术后早期复发中具有一定的临床应用价值。Objective To investigate the clinical value of left atrial strain parameters combined with left atrial appendage emptying velocity(LAAeV)in predicting early recurrence after persistent atrial fibrillation(PeAF)ablation.Methods A total of 122 PeAF patients undergoing catheter ablation in our hospital were prospectively enrolled,according to the results of a 3-month follow-up,they were divided into recurrence group and non-recurrence group.On the day of ablation,conventional echocardiography was used to obtain the left ventricular end-diastolic diameter(LVEDD),left atrial anteroposterior diameter(LAD),left atrial volume index(LAVI),left atrial ejection fraction(LAEF),and left ventricular ejection fraction(LVEF).Pulse Doppler was used to obtain the early diastolic peak velocity of mitral inflow(E),tissue Doppler was used to obtain the early diastolic mitral annular velocity(e’)at the septal and lateral walls,followed by calculation of E/e’.Transesophageal echocardiography(TEE)was used to obtain the LAAeV.Two-dimensional speckle tracking echocardiography(2D-STE)was used to obtain left ventricular global longitudinal strain(LVGLS),left atrial reservoir strain(LASr),left atrial conduit strain(LAScd),and left atrial pump strain(LASct).The differences of above parameters between the two groups were compared.Binary Logistic regression analysis was performed to identify independent predictors for predicting early recurrence after PeAF ablation.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic performance of individual and combined parameters in predicting early recurrence after PeAF ablation.Results Totally 74 PeAF patients were selected,including 26 cases in the recurrence group and 48 cases in the non-recurrence group.Significant differences were observed between the two groups in LAD,LAVI,LAAeV,LVGLS,LASr,and LASct(all P<0.05),while no significant differences were found in LVEDD,LAEF,LVEF,E/e’,and LAScd.Binary Logistic regression analysis identified that LAAeV,LASr,and LASct were inde

关 键 词：超声心动描记术 斑点追踪技术 二维 左房功能 左心耳排空速度 心房颤动 导管消融术 

分 类 号：R540.45[医药卫生—心血管疾病]