Application value of four-dimensional automic left atrial quantitation in evaluating left atrial fibrosis in patients with persistent atrial fibrillation
10.3760/cma.j.cn131148-20230625-00343
- VernacularTitle:四维自动左房定量技术评估持续性心房颤动患者左心房纤维化的应用价值
- Author:
Xuqian ZHANG
1
;
Yajing MIAO
;
Hong ZHOU
;
Gaojie HAN
;
Jing WANG
;
Qiaoli TONG
;
Shengnan ZHANG
;
Hongning YIN
Author Information
1. 河北医科大学第二医院心脏超声科，石家庄 050000
- Keywords:
Ultrasonography;
Persistent atrial fibrillation;
Four-dimensional automic left atrial quantitation;
Left atrial strain;
Electroanatomic voltage mapping
- From:
Chinese Journal of Ultrasonography
2023;32(11):995-1001
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the degree of left atrial fibrosis in patients with persistent atrial fibrillation(AF) using four-dimensional automic left atrial quantitation(4D Auto LAQ).Methods:A total of 60 patients with persistent AF who underwent transcatheter radiofrequency ablation in the Second Hospital of Hebei Medical University from March 2022 to March 2023 were included. Patients were grouped according to the low-voltage area (mild<5%, moderate 5%-20%, severe>20%). General clinical data, conventional echocardiogram parameters, left atrial strain and related parameters of each group were compared. The relevant factors were obtained by Logistic regression analysis. The factor with the highest accuracy and its cut-off value was obtained by the ROC curve.Results:Sixty patients with persistent atrial fibrillation, were divided into mild low-voltage group(22 cases), moderate low-voltage group(20 cases), and severe low-voltage group(18 cases). There were statistical differences in gender, CHA2DS2-VASc score, peak value of early diastolic velocity of mitral inflow/average peak value of early diastolic tissue Doppler velocity of mitral annulus (E/e′), left atrial diameter (LAD), left atrial volume index (LAVI), left atrial maximal volume (LAVmax), left atrial minimal volume (LAVmin), left atrial total emptying fraction (LAEF), left atrial reservoir longitudinal strain (LASr), left atrial reservoir circumferential strain (LASr-c), left atrial myocardial work (LA MW, LA MW-c), left atrial stiffness (LA stiffness, LA stiffness-c) among the 3 groups(all P<0.05). The LASr had the highest correlation with low voltage area ( rs=-0.814, P<0.001). Logistic regression analysis showed that CHA2DS2-VASc, LAD, LAVI, LAVmax, LAVmin, LAEF, LASr, LASr-C, LA MW, LA MW-C, LA stiffness and LA stiffness-c could all predict the low voltage area(all P<0.05). The LA stiffness had the highest AUC (0.952). The cut-off value of severe low voltage was 1.15, the sensitivity was 94.4%, and the specificity was 83.3%. Conclusions:4D Auto LAQ can be used to evaluate the degree of left atrial fibrosis. The correlation between LA stiffness and substrate voltage mapping is the highest.
