Kosmala Wojciech, Przewlocka-Kosmala Monika, Mazurek Walentyna
Cardiology Department, Medical University, Wroclaw Poland.
Europace. 2006 Feb;8(2):102-6. doi: 10.1093/europace/euj036. Epub 2006 Jan 10.
Mechanisms underlying lone atrial fibrillation (LAF) are poorly defined. We sought to investigate indices of left atrial (LA) function in patients with recurrent LAF, in comparison with that in healthy subjects.
Investigations were performed in 42 patients aged 51.8 +/- 8.7 at least 30 days after the last episode of LAF and in 38 healthy controls. Each subject underwent echocardiographic evaluation including left ventricular parameters and LA function indices. LA ejection fraction served as a measure of LA systolic performance, and acceleration (SAT) and deceleration time (SDT) of systolic phase of pulmonary venous flow (PVF) corresponded to LA relaxation and compliance, respectively. Patients with LAF showed significantly lower values of SAT (179.1 +/- 63.2 vs. 199.2 +/- 45.1 ms, P < 0.02) and higher values of SDT (250.8 +/- 81.6 vs. 211.7 +/- 57.3 ms, P < 0.01) when compared with controls. No significant differences were found with respect to other measured parameters. The combination of SAT < 185 ms and SDT > 239 ms showed a positive predictive value of 92% in the identification of patients prone to LAF.
This study suggests that (i) patients with LAF have abnormalities of the systolic phase of PVF and (ii) Doppler estimation of PVF seems to be very valuable in the evaluation of patients with LAF.
孤立性心房颤动（LAF）的潜在机制尚不明确。我们试图研究复发性LAF患者的左心房（LA）功能指标，并与健康受试者进行比较。
对42例年龄为51.8±8.7岁、在最后一次LAF发作至少30天后的患者以及38例健康对照者进行了研究。每位受试者均接受了超声心动图评估，包括左心室参数和LA功能指标。LA射血分数作为LA收缩功能的指标，肺静脉血流（PVF）收缩期的加速度（SAT）和减速时间（SDT）分别对应于LA的舒张和顺应性。与对照组相比，LAF患者的SAT值显著降低（179.1±63.2对199.2±45.1毫秒，P<0.02），SDT值显著升高（250.8±81.6对211.7±57.3毫秒，P<0.01）。在其他测量参数方面未发现显著差异。SAT<185毫秒和SDT>239毫秒的组合在识别易患LAF的患者中显示出92%的阳性预测值。
本研究表明，（i）LAF患者存在PVF收缩期异常，（ii）PVF的多普勒估计在LAF患者的评估中似乎非常有价值。
