Bai Ying, Zhao Ying, Li Jie, Zhang Ying, Bai Rong, Du Xin, Dong Jian-Zeng, He Yi-Hua, Ma Chang-Sheng
Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Ultrasound Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Intern Med J. 2018 Jul;48(7):851-859. doi: 10.1111/imj.13768.
Strain was shown associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA), but data on AF patients complicated with chronic lung diseases (CLD) were rare.
This study was designed to evaluate the relationship of baseline atrial function with AF recurrence in these patients using speckle-tracking echocardiography.
Average strain values (median: 2 days before RFA) were calculated for 87 AF patients (Mean age: 61.91 years, male: 71.26%) with CLD undergoing RFA from 2013 to 2014. Of these patients, 25 (28.74%) experienced AF recurrence during a mean follow up of 10.3 months.
Peak right atrial longitudinal strain (R-PALS) was associated with peak left atrial longitudinal strain (L-PALS, Standardised β = 0.45, P < 0.001) in multivariate linear regression. Multivariate Cox regression analysis showed R-PALS was associated with AF recurrence (hazard ratio, 0.86; 95% confidence interval (CI), 0.78-0.96, P = 0.005) in CLD. Patients with R-PALS ≥14.69% had higher AF free rate compared with R-PALS<14.69% using Kaplan-Meier analysis (log-rank, P < 0.001). R-PALS had similar C-index compared to L-PALS (difference: 0.03, 95%CI: -0.06-0.12, P = 0.53) and combined R-PALS and L-PALS (difference: 0.005, 95%CI: -0.04-0.05, P = 0.84) associated with AF recurrence in CLD.
R-PALS, L-PALS and combined R-PALS and L-PALS are important factors associated with AF recurrence following RFA in patients with CLD.
研究表明，应变与射频消融（RFA）术后房颤（AF）复发有关，但关于合并慢性肺部疾病（CLD）的AF患者的数据很少。
本研究旨在使用斑点追踪超声心动图评估这些患者的基线心房功能与AF复发之间的关系。
计算了2013年至2014年期间接受RFA的87例合并CLD的AF患者（平均年龄：61.91岁，男性：71.26%）的平均应变值（中位数：RFA前2天）。在平均10.3个月的随访期间，这些患者中有25例（28.74%）出现AF复发。
在多变量线性回归中，右心房纵向峰值应变（R-PALS）与左心房纵向峰值应变（L-PALS，标准化β = 0.45，P < 0.001）相关。多变量Cox回归分析显示，R-PALS与CLD患者的AF复发相关（风险比，0.86；95%置信区间（CI），0.78-0.96，P = 0.005）。使用Kaplan-Meier分析，R-PALS≥14.69%的患者与R-PALS<14.69%的患者相比，无AF率更高（对数秩，P < 0.001）。与L-PALS相比，R-PALS的C指数相似（差异：0.03，95%CI：-0.06-0.12，P = 0.53），并且R-PALS和L-PALS联合使用与CLD患者的AF复发相关（差异：0.005，95%CI：-0.04-0.05，P = 0.84）。
R-PALS、L-PALS以及R-PALS和L-PALS联合使用是CLD患者RFA术后AF复发的重要相关因素。
