Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Int J Cardiol. 2012 Sep 6;159(3):181-6. doi: 10.1016/j.ijcard.2011.02.053. Epub 2011 Mar 21.
To assess the functional differences among the three anatomic compartments of the left atrium (LA) using 64-multislice cardiac CT in controls and patients with atrial fibrillation (AF).
We examined 144 individuals (105 males, mean age 56.42 ± 12.04 years) undergoing 64-multislice cardiac CT and divided them into 48 control, 53 paroxysmal AF (PAF), and 43 persistent AF (PeAF) patients. The LA was divided into three anatomic compartments according to their embryologic origins: venous LA (VLA), anterior LA (ALA), and LA appendage (LAA). Each volume was calculated using a threshold-based, three-dimensional segmentation. The LA parameters were defined as maximum and minimum LA volume indices, emptying volume, and ejection fraction. We compared the LA parameters of each compartment in controls, PAF patients, and PeAF patients.
In each of the three LA compartments, the maximum LA volume index was lowest in controls (LAA, 4.8 ml/m(2); VLA, 18.3 ml/m(2); ALA, 37.1 ml/m(2)) and highest in PeAF patients (LAA, 9.8 ml/m(2); VLA, 30.0 ml/m(2); ALA, 67.3 ml/m(2)). Regarding the three LA compartments, the ejection fraction was highest in the LAA and lowest in the VLA in controls (LAA, 58.3%; VLA, 29.0%; ALA, 47.4%) and in PAF patients (LAA, 47.3%; VLA, 18.3%; ALA, 39.2%). In PeAF patients, the emptying volumes and ejection fractions of the VLA were approximately zero.
The anatomic compartments of the LA play different roles in AF patients. The LAA has both highest contractility and independent function, and the VLA is the most severely affected by LA dysfunction. Our results may be helpful in understanding the pathophysiology of AF and predicting treatment responses to radiofrequency ablation in the future.
利用 64 层心脏 CT 评估左心房（LA）的三个解剖腔室在对照组和心房颤动（AF）患者中的功能差异。
我们检查了 144 名接受 64 层心脏 CT 检查的个体（105 名男性，平均年龄 56.42±12.04 岁），并将他们分为 48 名对照组、53 名阵发性 AF（PAF）患者和 43 名持续性 AF（PeAF）患者。根据胚胎起源将 LA 分为三个解剖腔室：静脉 LA（VLA）、前 LA（ALA）和 LA 附件（LAA）。使用基于阈值的三维分割计算每个腔室的容积。LA 参数定义为最大和最小 LA 容积指数、排空容积和射血分数。我们比较了对照组、PAF 患者和 PeAF 患者每个腔室的 LA 参数。
在 LA 的三个腔室中，最大 LA 容积指数在对照组中最低（LAA，4.8ml/m²；VLA，18.3ml/m²；ALA，37.1ml/m²），在 PeAF 患者中最高（LAA，9.8ml/m²；VLA，30.0ml/m²；ALA，67.3ml/m²）。在 LA 的三个腔室中，对照组中 LAA 的射血分数最高，VLA 最低（LAA，58.3%；VLA，29.0%；ALA，47.4%）和 PAF 患者（LAA，47.3%；VLA，18.3%；ALA，39.2%）。在 PeAF 患者中，VLA 的排空容积和射血分数几乎为零。
LA 的解剖腔室在 AF 患者中发挥不同的作用。LAA 具有最高的收缩性和独立功能，VLA 受 LA 功能障碍的影响最严重。我们的研究结果可能有助于理解 AF 的病理生理学，并为未来预测射频消融治疗的反应提供帮助。
