Dordevic Aleksandar, Genger Martin, Schwarz Carsten, Cuspidi Cesare, Tahirovic Elvis, Pieske Burkert, Düngen Hans-Dirk, Tadic Marijana
Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, CF Center/Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
J Clin Med. 2019 Jul 31;8(8):1141. doi: 10.3390/jcm8081141.
Previous studies have focused on left and right ventricular remodeling in cystic fibrosis (CF), whereas atrial function has not been assessed in detail so far. We sought to investigate left and right atrial (LA and RA) function in patients with CF.
This retrospective investigation included 82 CF patients (64 survivors and 18 non-survivors) who were referred to CF department over the period of four years, as well as 32 control subjects matched by age and gender. All participants underwent an echocardiographic examination including a strain analysis, which was performed offline and blinded for groups.
LA and RA volume indexes were significantly higher in CF patients than in controls and were particularly high in CF non-survivors. LA conduit and reservoir functions were significantly worse in CF survivors and non-survivors, compared with control subjects. RA phasic function was not different between controls, CF survivors and non-survivors. The parameters of lung function (forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1)) and the LA and RA volume indexes were predictors of mortality in CF patients. However, in a multivariate analysis, only FVC was an independent predictor of mortality in CF patients.
Our results suggest that both atria are enlarged, but only LA function is impaired in CF patients. LA reservoir and conduit function is particularly deteriorated in CF patients. Though statistical significance was not reached due to our limited sample size, there was a trend of deterioration of LA and RA function from controls across CF survivors to CF non-survivors. LA and RA enlargement represented predictors of mortality in CF patients.
以往的研究主要关注囊性纤维化（CF）患者的左、右心室重塑，而心房功能至今尚未得到详细评估。我们旨在研究CF患者的左、右心房（LA和RA）功能。
这项回顾性研究纳入了82例CF患者（64例存活者和18例非存活者），这些患者在四年内被转诊至CF科室，以及32例年龄和性别匹配的对照受试者。所有参与者均接受了超声心动图检查，包括应变分析，该分析在离线状态下进行，且对分组情况不知情。
CF患者的LA和RA容积指数显著高于对照组，在CF非存活者中尤其高。与对照受试者相比，CF存活者和非存活者的LA管道和储存功能明显较差。对照组、CF存活者和非存活者之间的RA相位功能没有差异。肺功能参数（用力肺活量（FVC）和第1秒用力呼气量（FEV1））以及LA和RA容积指数是CF患者死亡率的预测指标。然而，在多变量分析中，只有FVC是CF患者死亡率的独立预测指标。
我们的结果表明，CF患者的两个心房均增大，但只有LA功能受损。CF患者的LA储存和管道功能尤其恶化。尽管由于样本量有限未达到统计学显著性，但从对照组到CF存活者再到CF非存活者，LA和RA功能有恶化的趋势。LA和RA增大是CF患者死亡率的预测指标。
