Yaroslav Ashikhmin, Oxana Drapkina
Internal Medicine Department, International Medical Cluster, Moscow, Russia.
Cardiology Department, National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation. Moscow, Russia.
Arch Cardiol Mex. 2022 Oct 21;92(4):431-437. doi: 10.24875/ACM.21000135.
The aim of the study was to investigate atrial contractile function in patients with paroxysmal atrial fibrillation (AF) in sinus rhythm using transthoracic echocardiography (EchoCG).
Thirty-five patients with paroxysmal AF and arterial hypertension (mean age 62 ± 10 years, 43% male) in sinus rhythm were enrolled in the study. The control group was composed of comparable patients with arterial hypertension without heart rhythm disturbances. EchoCG was performed during sinus rhythm according to an extended protocol, which included the ejection fraction (EF) of the left atrium (LA) and tissue Doppler measurements. Myocardial fibrosis was assessed quantitatively by videodensitometry in intraventricular and intraatrial (IAS) septa using an original image post-processing algorithm. We found a significant decrease in the left atrial contraction function during sinus rhythm in patients with AF when compared to controls. LA EF (34 ± 14 vs. 54 ± 17, p = 0.03) and A' velocity (0.17 ± 0.04 vs. 0.22 ± 0.04, p = 0.008) decreased while A/A' ratio (2.7 ± 0.2 vs. 1.9 ± 0.1, p = 0.006) increased. Peak A velocity was not affected. Videodensitometric analysis revealed a 2.3-fold increase in IAS fibrosis fraction in AF patients compared with controls (p = 0.01).
Patients with AF in sinus rhythm have markedly depressed atrial contractile function. Videodensitometry of IAS has the potential to be used as inexpensive method of atrial fibrosis assessment in patients with AF.
本研究旨在使用经胸超声心动图（EchoCG）研究阵发性心房颤动（AF）患者在窦性心律时的心房收缩功能。
35例窦性心律的阵发性AF合并动脉高血压患者（平均年龄62±10岁，43%为男性）纳入本研究。对照组由无心律紊乱的动脉高血压患者组成。在窦性心律期间，按照扩展方案进行EchoCG检查，包括测量左心房（LA）射血分数（EF）和组织多普勒。使用原始图像后处理算法，通过心室和心房（IAS）间隔的视频密度测定法定量评估心肌纤维化。我们发现，与对照组相比，AF患者在窦性心律时左心房收缩功能显著降低。LA EF（34±14对54±17，p = 0.03）和A'速度（0.17±0.04对0.22±0.04，p = 0.008）降低，而A/A'比值（2.7±0.2对1.9±0.1，p = 0.006）升高。A峰速度不受影响。视频密度测定分析显示，AF患者的IAS纤维化分数比对照组增加了2.3倍（p = 0.01）。
窦性心律的AF患者心房收缩功能明显降低。IAS的视频密度测定法有可能作为一种廉价的方法用于评估AF患者的心房纤维化。
