Vitarelli Antonio, Gaudio Carlo, Mangieri Enrico, Capotosto Lidia, Tanzilli Gaetano, Ricci Serafino, Viceconte Nicola, Placanica Attilio, Placanica Giuseppe, Ashurov Rasul
Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy.
Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy.
Ultrasound Med Biol. 2018 Jun;44(6):1198-1211. doi: 10.1016/j.ultrasmedbio.2018.02.015. Epub 2018 Mar 30.
Our aim was to analyze atrial function with 2-D (2-D-STE) and 3-D (3-D-STE) speckle tracking echocardiography in patients with atrial septal devices and paroxysmal atrial fibrillation (PAF). One hundred sixteen patients and a subgroup of 22 patients who developed PAF after device insertion were studied. Left atrial and right atrial peak longitudinal strain and standard deviations of time to peak strain (TPS) were calculated using 2-D-STE. The left atrial/right atrial emptying fraction and expansion index were determined using 3-D-STE. By multivariate analysis, pre-closure 3-D right atrial expansion index, left atrial time to peak strain, and 3-D left atrial expansion index were independently associated with PAF. Compared with the other indices, receiver operating characteristic analysis revealed better diagnostic accuracy for the combination of pre-closure time to peak strain and 3-D expansion index in detecting PAF. Patients with atrial septal devices have pre-existing left and right atrial dilation and dysfunction as assessed by 2-D-STE and 3-D-STE that appear sensitive for the stratification of PAF risk in this population.
我们的目的是利用二维（2-D-STE）和三维（3-D-STE）斑点追踪超声心动图分析房间隔封堵器植入患者及阵发性心房颤动（PAF）患者的心房功能。研究了116例患者以及其中22例在封堵器植入后发生PAF的亚组患者。使用2-D-STE计算左心房和右心房的峰值纵向应变以及达到峰值应变时间（TPS）的标准差。使用3-D-STE测定左心房/右心房排空分数和扩张指数。通过多因素分析，封堵前三维右心房扩张指数、左心房达到峰值应变时间和三维左心房扩张指数与PAF独立相关。与其他指标相比，受试者工作特征分析显示，封堵前达到峰值应变时间与三维扩张指数联合检测PAF的诊断准确性更高。二维斑点追踪超声心动图和三维斑点追踪超声心动图评估显示，房间隔封堵器植入患者存在左、右心房预先扩张及功能障碍，这对于该人群PAF风险分层似乎较为敏感。
