Left atrial quantitative ultrasonic analysis in predicting the recurrence of atrial fibrillation after ablation
10.3760/cma.j.issn.1004-4477.2017.08.002
- VernacularTitle:左心房超声定量分析对心房颤动患者消融术后复发的预测价值
- Author:
Feng DING
1
;
Hongning SONG
;
Jinling CHEN
;
Qing ZHOU
;
Tuantuan TAN
;
Bo HU
;
Sheng CAO
;
Ruiqiang GUO
Author Information
1. 430060,武汉大学人民医院超声影像科
- Keywords:
Echocardiograhy;
Atrial fibrillation;
Radiofrequency ablation;
Two-dimensional speckle tracking imaging;
Strain
- From:
Chinese Journal of Ultrasonography
2017;26(8):650-656
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictive value of radiofrequency catheter ablation (RFCA) in patients with atrial fibrillation by measuring the left atrial structure and functional parameters with quantitative echocardiography.Methods One hundred and two patients with atrial fibrillation underwent radiofrequency ablation and 22 healthy cases as control group were enrolled in this study.Early diastolic strain(Se),global diastolic strain(Sg),late diastolic strain (Sa =Sg-Se),early diastolic strain rate (SRe),late diastolic strain rate(SRa),systolic strain rate (SRs) were measured.The standard deviations were calculated by time to peak of strain and strain rate.Left atrial maximum volume (LAVmax) and left atrial minimum volume (LAVmin) were measured.Left atrial stroke volume (LASV) and left atrial ejection fraction (LAEF) were calculated.The regression equation was obtained by binary logistic regression analysis.The individual probabilistic variables generated in the SPSS worksheet were selected to plot the multivariate ROC curve to determine the area undercurve (AUC) and the optimal cutoff point.Results In the group of paroxysmal atrial fibrillation:Sg,Se,Em decreased and TPSR-SD,TPSRs-SD increased significantly (P <0.05) in the relapsed patients;The logistic regression equation was P =1/[1 + e-(3.994+0.22×Se+0.115×Sg+0.04×TPSReSD-0.354×Em+0.02×TPSRsSD)].With P≥0.202 as thecut-off,the sensitivity and specificity of recurrence were the highest,88.9% and 89.4% respectively.In the group of persistent atrial fibrillation:the SRs,LAEF and LASV decreased and E/Em increased (P <0.05) in the relapsed patients.The logistic regression equation was P =1/[1 + e-(1.139-0.102LASV +0.348×E/Em-3.266×LAEF 0.417×SRs)].With P≥ 0.502 as thecut off,the sensitivity and specificity of recurrence were the highest,77.3% and 79.2% respectively.Conclusions Left atrial ultrasound quantitative analysis techniques to atrial fibrillation ablation recurrence have good predictive value.The recurrence of paroxysmal atrial fibrillation can be predicted by the strain rate and the standard deviation of time to peak of strain rate,and the persistent atrial fibrillation by LASV,LAEFand SRs.The multivariate analysis shows a higher predictive value.