Jacuś Beata, Milewska Anna, Miękus Paweł, Konarzewski Marcin, Daniłowicz-Szymanowicz Ludmiła, Lubiński Andrzej, Grześk Grzegorz
Medical University of Gdańsk, Nicolaus Copernicus University in Toruń, Gdańsk, Poland.
Cardiology and Internal Medicine Department, University Center for Maritime and Tropical Medicine in Gdynia, Gdynia, Poland.
Clin Cardiol. 2025 Apr;48(4):e70114. doi: 10.1002/clc.70114.
Atrial fibrillation is the most common arrhythmia worldwide, affecting between 2% and 4% of population. The projected further progression is a reason to consider AF as a global epidemic problem. The efficiency in diagnosing new cases is still unsatisfactory.
The prospective study included 74 patients hospitalized for acute myocardial infarction. Echocardiography with advanced assessment of the left atrium was performed on all patients. R Statistical Software was used for statistical and graphical processing.
Atrial fibrillation was first diagnosed in 13.5% of patients with acute myocardial infarction, and in 5.4% of the patients the diagnosis was made during the long-term follow-up period. Analysis of the data collected showed that patients with arrythmia were older (71.79 vs 63.5 years; p = 0.047), had a higher BMI (30.15 vs 26.76 kg/m; p = 0.039) and had a higher CHADS VASc score (4.14 vs 3.02 points). Among the echocardiographic parameters, those that significantly differentiated patients with arrythmia included larger LA area (21.62 vs 18.84 cm; p = 0.027), lower LAEF 4CH (43.46 vs 55.93%; p = 0.029), lower LAEF mean (44.08 vs 55.63%; p = 0.014), lower EI (1.03 vs 1.49; p = 0.032), lower LASr 4CH (19.08 vs 26.72%; p = 0.020), lower LASr mean (18.62 vs 26.73%; p = 0.009), higher E/e' (12.62 vs 9.58; p = 0.01), higher LASI (0.95 vs 0.45; p = 0.016).
Among the echocardiographic parameters, those that may indicate an increased risk of atrial fibrillation and could be implemented in clinical practice are LASr and LASI. Determining them in risk profiling and the implementation of individualized arrhythmia detection methods could increase diagnostic efficiency.
心房颤动是全球最常见的心律失常，影响着2%至4%的人口。预计其进一步发展是将房颤视为全球流行问题的一个原因。诊断新病例的效率仍不尽人意。
前瞻性研究纳入了74例因急性心肌梗死住院的患者。对所有患者进行了左心房高级评估的超声心动图检查。使用R统计软件进行统计和图形处理。
13.5%的急性心肌梗死患者首次诊断出心房颤动，5.4%的患者在长期随访期间确诊。对收集到的数据进行分析显示，心律失常患者年龄更大（71.79岁对63.5岁；p = 0.047），BMI更高（30.15对26.76kg/m；p = 0.039），CHADS VASc评分更高（4.14对3.02分）。在超声心动图参数中，能显著区分心律失常患者的参数包括左心房面积更大（21.62对18.84cm；p = 0.027），四腔心切面左心房射血分数更低（43.46%对55.93%；p = 0.029），平均左心房射血分数更低（44.08%对55.63%；p = 0.014），E/A比值更低（1.03对1.49；p = 0.032），四腔心切面左心房储存期应变率更低（19.08%对26.72%；p = 0.020），平均左心房储存期应变率更低（18.62%对26.73%；p = 0.009），E/e'更高（12.62对9.58；p = 0.01），左心房主动应变指数更高（0.95对0.45；p = 0.016）。
在超声心动图参数中，可能提示心房颤动风险增加且可应用于临床实践的参数是左心房储存期应变率和左心房主动应变指数。在风险评估中确定这些参数并实施个体化心律失常检测方法可提高诊断效率。
