Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China.
Department of Pain Management, Peking University Shenzhen Hospital, Shenzhen, China.
Acta Cardiol. 2023 May;78(3):331-340. doi: 10.1080/00015385.2022.2076308. Epub 2022 Jul 29.
By using ultrasound strain rate (SR) imaging to evaluate the left atrial (LA) reservoir and pump function after catheter ablation (CA) with persistent atrial fibrillation (PAF).
A total of 45 patients with PAF underwent echocardiography examination before and after ablation as well as during 6 months of follow-up. Peak SR was measured at each LA segment (septal, lateral, anterior, inferior and posterior) during systole (LAs) and late diastole (LAa).
During 6 months after CA, 30 patients were free of atrial fibrillation recurrence (AFR). left atrial area index (LAAI), left atrial maximum volume index (LAVImax), and E/Ea were obviously higher in patients with before CA, left atrial ejection fraction (LAEF), SR-LAs were lower than in normal cases, the SR-LAa was disappeared. Shortly after ablation, SR-LAa was recovered, and SR-LAs was reduced compared to those at baseline. At midterm follow-up, LAEF and SR-LAs were still lower than the control group, and LAAI and LAVImax were higher. SR-LAa was recovered slowly over time, but still lower.
LA reservoir function was seriously damaged and LA pump function disappeared in patients with PAF. LA reservoir function impairment appeared shortly after ablation, it showed improvement at midterm follow-up, but some degree of damage to the LA reservoir and pump function was still present. Speckle tracking imaging is a feasible technique for the assessment of LA function in patients with PAF, which is a potentially valuable clinical tool to assist in the early detection of atrial remodelling and reverse remodelling.
应用超声应变率（SR）成像技术评价导管消融（CA）治疗持续性心房颤动（PAF）后左心房（LA）储器和泵功能。
共 45 例 PAF 患者在消融前、消融后及随访 6 个月时进行超声心动图检查。测量收缩期（LAs）和舒张晚期（LAa）各 LA 节段（间隔、侧壁、前壁、下壁和后壁）的峰值 SR。
CA 后 6 个月，30 例患者无房颤复发（AFR）。与正常对照组相比，消融前患者的左心房面积指数（LAAI）、左心房最大容积指数（LAVImax）和 E/Ea 明显升高，左心房射血分数（LAEF）、SR-LAs 降低，SR-LAa 消失。消融后即刻，SR-LAa 恢复，SR-LAs 较基线降低。中期随访时，LAEF 和 SR-LAs 仍低于对照组，而 LAAI 和 LAVImax 则较高。SR-LAa 随时间缓慢恢复，但仍较低。
PAF 患者的 LA 储器功能严重受损，LA 泵功能丧失。LA 储器功能障碍在消融后即刻出现，中期随访时有所改善，但 LA 储器和泵功能仍存在一定程度的损伤。斑点追踪成像技术是评估 PAF 患者 LA 功能的一种可行技术，是一种有潜在价值的临床工具，可帮助早期发现心房重构和逆转重构。
