Department of Cardiology, Leiden University Medical Center, the Netherlands.
J Am Coll Cardiol. 2011 Jan 18;57(3):324-31. doi: 10.1016/j.jacc.2010.05.063.
The purpose of this study was to assess left atrial (LA) strain during long-term follow-up after catheter ablation for atrial fibrillation and to find predictors for LA reverse remodeling.
The association between LA reverse remodeling and improvement in LA strain after catheter ablation has not been investigated thus far.
In 148 patients undergoing catheter ablation for atrial fibrillation, LA volumes and LA strain were assessed with echocardiography at baseline and after a mean of 13.2 ± 6.7 months of follow-up. The study population was divided according to LA reverse remodeling at follow-up: responders were defined as patients who exhibited 15% or more reduction in maximum LA volume at long-term follow-up. Left atrial systolic (LAs) strain was assessed with tissue Doppler imaging.
At follow-up, 93 patients (63%) were classified as responders, whereas 55 patients (37%) were nonresponders. At baseline, LAs strain was significantly higher in the responders as compared with the nonresponders (19 ± 8% vs. 14 ± 6%; p = 0.001). Among the responders, a significant increase in LAs strain was noted from baseline to follow-up (from 19 ± 8% to 22 ± 9%; p < 0.05), whereas no change was noted among the nonresponders. LAs strain at baseline was an independent predictor of LA reverse remodeling (odds ratio: 1.813; 95% confidence interval: 1.102 to 2.982; p = 0.019).
In the present study, 63% of the patients exhibited LA reverse remodeling after catheter ablation for atrial fibrillation, with a concomitant improvement in LA strain. LA strain at baseline was an independent predictor of LA reverse remodeling.
本研究旨在评估心房颤动导管消融治疗后长期随访中左心房(LA)应变,并寻找 LA 逆重构的预测因素。
LA 逆重构与导管消融后 LA 应变改善之间的关系尚未得到研究。
在 148 例行导管消融治疗心房颤动的患者中,基线时和平均随访 13.2±6.7 个月后使用超声心动图评估 LA 容积和 LA 应变。根据长期随访时的 LA 逆重构将研究人群分为两组:应答者定义为最大 LA 容积在长期随访时减少 15%或更多的患者。使用组织多普勒成像评估 LA 收缩应变。
随访时,93 例(63%)患者被归类为应答者,55 例(37%)患者为无应答者。基线时,应答者的 LAs 应变明显高于无应答者(19±8%比 14±6%;p=0.001)。在应答者中,从基线到随访时 LAs 应变显著增加(从 19±8%增加到 22±9%;p<0.05),而无应答者则无变化。基线时的 LAs 应变是 LA 逆重构的独立预测因素(比值比:1.813;95%置信区间:1.102 至 2.982;p=0.019)。
在本研究中,63%的心房颤动导管消融治疗患者出现 LA 逆重构,同时 LA 应变得到改善。基线时的 LA 应变是 LA 逆重构的独立预测因素。