Department of Cardiology KARS, Faculty of Medicine, Kafkas University, Kars, Turkey.
Int J Cardiovasc Imaging. 2024 Feb;40(2):321-330. doi: 10.1007/s10554-023-02990-z. Epub 2023 Nov 21.
Atrial high-rate episodes (AHRE) defined as atrial tachy-arrhythmias, detected through continuous monitoring with a cardiac implantable electronic device (CIED). AHRE's have been associated with increased risks of developing clinically manifested atrial fibrillation, thromboembolism, cardiovascular events, and mortality. Several variables have been researched and identified to predict AHRE existence. The present study evaluated the association between right-heart structural and functional echocardiographic parameters and AHRE in patients with CIEDs and impaired LVEF. This prospective design study included 194 patients with CIED's. The study population was divided into two groups according to presence of AHRE and analyzed the echocardiographic variables which may able to be a predictor of AHRE. Patients was divided into two groups: patients with AHRE (+) and without AHRE (-). The distribution of patients' characteristics according to presence of AHRE was analyzed. The multivariate analysis revealed Age, LAVI, E/Em tricuspid (HR: 1.106, 1.015-1.205% 95 CI; p = 0.022) and RAVI (HR: 1.035, 1.003-1.069 95% CI; p = 0.033) as independent predictors of AHREs. ROC curve analysis indicated that an E/Em tricuspid (AUC: 0.611, 95% CI 0.538-0.680 p: 0.009) and RAVI (AUC = AUC: 0.707, 95% CI 0.637-0.770 p < 0.001) predicted AHREs with a cut-off value of 6.28 and a sensitivity of 53.2% and specificity of 66.7% and a cut-off value of 29.5 mL/m with a sensitivity of 72.7% and a specificity of 65.9%, respectively. The main finding of this study was "RAVI" and "E/Emtricuspid ratio" is associated with AHRE. Additionally, "RAVI" and "E/Emtricuspid ratio" is an independent predictor of AHRE existence.
心房高频事件 (AHRE) 定义为通过心脏植入式电子设备 (CIED) 进行连续监测检测到的房性心动过速-心律失常。AHRE 与发展为临床明显的心房颤动、血栓栓塞、心血管事件和死亡率增加有关。已经研究并确定了几种变量来预测 AHRE 的存在。本研究评估了 CIED 和左心室射血分数受损患者右心结构和功能超声心动图参数与 AHRE 之间的关系。这项前瞻性设计研究包括 194 名接受 CIED 的患者。根据 AHRE 的存在将研究人群分为两组，并分析了可能成为 AHRE 预测因子的超声心动图变量。患者分为两组：AHRE(+)和无 AHRE(-)。根据 AHRE 的存在分析了患者特征的分布。多变量分析显示年龄、左心房容积指数、三尖瓣 E/Em（HR：1.106，1.015-1.205%95%CI；p=0.022）和右心房容积指数（HR：1.035，1.003-1.069 95%CI；p=0.033）是 AHRE 的独立预测因子。ROC 曲线分析表明，三尖瓣 E/Em（AUC：0.611，95%CI 0.538-0.680 p：0.009）和右心房容积指数（AUC=0.707，95%CI 0.637-0.770 p<0.001）的预测值具有截断值 6.28 和敏感性 53.2%和特异性 66.7%以及截断值 29.5 mL/m，敏感性为 72.7%，特异性为 65.9%。这项研究的主要发现是“右心房容积指数”和“三尖瓣 E/Em 比值”与 AHRE 相关。此外，“右心房容积指数”和“三尖瓣 E/Em 比值”是 AHRE 存在的独立预测因子。
