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Automatic Echocardiographic Assessment of Left Atrial Function for Prediction of Low-Voltage Areas in Non-Valvular Atrial Fibrillation.

作者信息

Chang Shuai, Zhang Xiaofeng, Ge Chenliang, Zhong Yanfen, Zeng Decai, Cai Yongzhi, Huang Tongtong, Wu Ji

机构信息

Department of Ultrasonic Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.

Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.

出版信息

Int J Gen Med. 2024 Oct 2;17:4493-4506. doi: 10.2147/IJGM.S477499. eCollection 2024.


DOI:10.2147/IJGM.S477499
PMID:39372132
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456279/
Abstract

PURPOSE: Left atrial low-voltage areas (LA-LVAs) identified by 3D-electroanatomical mapping are crucial for determining treatment strategies and prognosis in patients with atrial fibrillation (AF). However, convenient and accurate prediction of LA-LVAs remains challenging. This study aimed to assess the viability of utilizing automatically obtained echocardiographic parameters to predict the presence of LA-LVAs in patients with non-valvular atrial fibrillation (NVAF). PATIENTS AND METHODS: This retrospective study included 190 NVAF patients who underwent initial catheter ablation. Before ablation, echocardiographic data were obtained, left atrial volume and strain were automatically calculated using advanced software (Dynamic-HeartModel and AutoStrain). Electroanatomic mapping (EAM) was also performed. Results were compared between patients with LA-LVAs ≥5% (LVAs group) and <5% (non-LVAs group). RESULTS: LA-LVAs were observed in 81 patients (42.6%), with a significantly higher incidence in those with persistent AF than paroxysmal AF (55.6% vs 19.3%, 0.001). Compared with the non-LVAs group, the LVAs group included significantly older patients, lower left ventricular ejection fraction, higher heart rate, and higher E/e' ratio ( <0.05). The LVAs group exhibited higher left atrial volume index (LAVi) and lower left atrial reservoir strain (LASr) ( <0.001). In multivariate analysis, both LAVi and LASr emerged as independent indicators of LVAs (OR 0.85; 95% CI 0.80-0.90, <0.001) and (OR 1.15, 95% CI 1.02-1.29, =0.021). ROC analysis demonstrated good predictive capacity for LA-LVAs, with an AUC of 0.733 (95% CI 0.650-0.794, <0.001) for LAVi and 0.839 (95% CI 0.779-0.898, <0.001) for LASr. CONCLUSION: Automatic assessment of LAVi and LASr presents a promising non-invasive modality for predicting the presence of LA-LVAs and evaluating significant atrial remodeling in NVAF patients. This approach holds potential for aiding in risk stratification and treatment decision-making, ultimately improving clinical outcomes in patients.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/5146317ed4c4/IJGM-17-4493-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/c305f4c1452d/IJGM-17-4493-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/a696357a22d2/IJGM-17-4493-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/b3785c4de379/IJGM-17-4493-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/922d4d9055f6/IJGM-17-4493-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/5146317ed4c4/IJGM-17-4493-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/c305f4c1452d/IJGM-17-4493-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/a696357a22d2/IJGM-17-4493-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/b3785c4de379/IJGM-17-4493-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/922d4d9055f6/IJGM-17-4493-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f83f/11456279/5146317ed4c4/IJGM-17-4493-g0005.jpg

相似文献

[1]
Automatic Echocardiographic Assessment of Left Atrial Function for Prediction of Low-Voltage Areas in Non-Valvular Atrial Fibrillation.

Int J Gen Med. 2024-10-2

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Application of artificial intelligence in echocardiography from 2009 to 2024: a bibliometric analysis.

Front Med (Lausanne). 2025-7-29

[2]
Clinical, Electrocardiographic and Echocardiographic Predictors of Atrial Fibrillation Recurrence After Pulmonary Vein Isolation.

J Clin Med. 2025-1-26

本文引用的文献

[1]
Combination of Epicardial Adipose Tissue and Left Atrial Low-Voltage Areas Predicting Atrial Fibrillation Recurrence after Radiofrequency Ablation.

Cardiology. 2025

[2]
Left atrial low voltage areas and heart failure in patients with atrial fibrillation: Implication of the atrial myopathy.

ESC Heart Fail. 2024-10

[3]
Safety and effectiveness of additional left atrial posterior wall ablation using pulsed field ablation for persistent and long-standing persistent atrial fibrillation patients.

J Cardiovasc Electrophysiol. 2024-8

[4]
Changes in left atrial function following two regimens of combined exercise training in patients with ischemic cardiomyopathy: a pilot study.

Front Cardiovasc Med. 2024-5-7

[5]
Left atrial low-voltage areas, but not volume, predict the recurrence of atrial fibrillation in repeat ablation procedures.

J Cardiovasc Electrophysiol. 2024-6

[6]
Predictors of improvement in left ventricular systolic function after catheter ablation in patients with persistent atrial fibrillation complicated with heart failure.

BMC Cardiovasc Disord. 2024-3-23

[7]
Left Atrial Low Voltage Areas Predicts Recurrence of Atrial Fibrillation after Catheter Ablation: A Meta-Analysis.

Heart Surg Forum. 2024-1-21

[8]
Left Atrial Low-Voltage Areas Predict the Risk of Atrial Fibrillation Recurrence after Radiofrequency Ablation.

Biomedicines. 2023-12-9

[9]
Impact of Posterior Left Atrial Voltage on Ablation Outcomes in Persistent Atrial Fibrillation: CAPLA Substudy.

JACC Clin Electrophysiol. 2023-11

[10]
Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results.

Europace. 2023-8-2

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