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使用二维斑点追踪超声心动图评估预激综合征患者的心房颤动及易损性

Assessment of atrial fibrillation and vulnerability in patients with Wolff-Parkinson-White syndrome using two-dimensional speckle tracking echocardiography.

作者信息

Li Jing-Jie, Wei Fang, Chen Ju-Gang, Yu Yan-Wei, Gu Hong-Yue, Jiang Rui, Wu Xiu-Li, Sun Qian

机构信息

Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China.

Departments of Cardiology, General Hospital of Taiyuan Iron and Steel Company, Taiyuan, P.R. China.

出版信息

PLoS One. 2014 Nov 14;9(11):e108315. doi: 10.1371/journal.pone.0108315. eCollection 2014.

Abstract

PURPOSE

The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE).

METHODS

All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls.

RESULTS

Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both P<0.05). Echocardiography revealed that the maximum left atrial volume (LAVmax) and the left ventricular mass index (LVMI) in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05). Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA) in the WPW patients group compared with patients in the DAVNP group (all P<0.05). In the AF group, there were significant differences in the levels of systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) from the 4-chamber view (LA) both before and after ablation (all P<0.05). In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA) pre-ablation compared to post-ablation (all P<0.05).

CONCLUSION

Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period.

摘要

目的

旨在使用二维斑点追踪超声心动图(2D-STE)评估预激综合征(WPW)患者的心房颤动(AF)及易损性。

方法

所有患者均接受经胸超声心动图和2D-STE检查,以评估射频导管消融术前7天和术后10天的心房功能。术后通过门诊就诊或电话进行3个月的随访。

结果

结果显示,WPW患者与房室结双径路非折返性室上性心动过速(DAVNP)患者的体重指数(BMI)和室上性心动过速(SVT)持续时间均存在显著差异(均P<0.05)。超声心动图显示,与DAVNP患者相比,WPW患者在消融前后的舒张末期最大左心房容积(LAVmax)和左心室质量指数(LVMI)均显著增加(均P<0.05)。消融前,WPW患者组与DAVNP患者组相比,四腔心切面(LA)的SRs、SRe和SRa水平存在明显差异(均P<0.05)。在AF组中,消融前后四腔心切面(LA)的收缩期应变率(SRs)、舒张早期应变率(SRe)和舒张晚期应变率(SRa)水平均存在显著差异(均P<0.05)。在非AF组中,消融前四腔心切面(LA/RA)的SRe水平较消融后降低(均P<0.05)。

结论

我们的研究结果提供了令人信服的证据,表明WPW综合征可能导致心房易损性增加,并促进AF的发生。此外,射频导管消融房室附加旁道可能改善WPW综合征患者的心房功能。在长期随访中评估和改善射频导管消融的整体功能时,对WPW患者进行二维斑点追踪超声心动图成像将是必要的。

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Incessant tachycardia after radiofrequency ablation of accessory pathway.房室旁道射频消融术后持续性心动过速
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