Yu Zhi-Xi, Yang Wen, Yin Wei-Si, Peng Ke-Xin, Pan Yi-Lin, Chen Wei-Wei, Du Bei-Bei, He Yu-Quan, Yang Ping
Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China.
Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China.
World J Clin Cases. 2022 Aug 16;10(23):8063-8075. doi: 10.12998/wjcc.v10.i23.8063.
Rhythm control is the core part of the integrated management of atrial fibrillation (AF), especially in the early stages. Despite advances in catheter ablation (CA), the recurrence rate of AF after CA remains high. As a result, stratification and early management of AF recurrence after CA are critical. Currently, predictors of recurrence of AF after CA are mostly based on dysfunction caused by structural remodeling, apart from traditional risk factors. Atrial strain is a recently developed important parameter for detecting the deformability of atrial myocardium during the cardiac cycle prior to atrial remodeling. Although there is only preliminary evidence, atrial strain is still a promising parameter in predicting the recurrence of AF after CA at an early stage. This review focuses on the evaluation of atrial strain, the current applications of atrial strain in assessing atrial function, and predicting the recurrence of AF after CA. We summarize the contents related as follows: (1) CA for rhythm control in AF; (2) Evaluation methods of atrial strain; (3) Atrial strain in the remodeling and reverse remodeling of AF; and (4) Clinical applications of atrial strain in predicting the recurrence of AF after CA. Although there is accumulating evidence on the role of decreased atrial strain in the early prediction of AF recurrence, atrial strain is limited in clinical practice for lacking exact cut-off values and difficulty in distinguishing specific function phases of the atrium. More research is needed in the future to add strength to the early prediction value of atrial strain in AF recurrences.
节律控制是心房颤动（AF）综合管理的核心部分，尤其是在早期阶段。尽管导管消融（CA）技术取得了进展，但CA术后AF的复发率仍然很高。因此，CA术后AF复发的分层和早期管理至关重要。目前，除了传统危险因素外，CA术后AF复发的预测指标大多基于结构重塑导致的功能障碍。心房应变是最近开发的一个重要参数，用于检测心房重塑前心动周期中心房心肌的可变形性。尽管只有初步证据，但心房应变在早期预测CA术后AF复发方面仍是一个有前景的参数。本综述重点关注心房应变的评估、心房应变在评估心房功能以及预测CA术后AF复发方面的当前应用。我们将相关内容总结如下：（1）AF节律控制的CA；（2）心房应变的评估方法；（3）AF重塑和逆向重塑中的心房应变；以及（4）心房应变在预测CA术后AF复发中的临床应用。尽管有越来越多的证据表明心房应变降低在AF复发早期预测中的作用，但由于缺乏确切的临界值以及难以区分心房的特定功能阶段，心房应变在临床实践中受到限制。未来需要更多的研究来增强心房应变在AF复发早期预测价值方面的力度。
