Zivanic Aleksandra, Gajic Milan, Milovanovic Nikola, Neskovic Sofija Aleksandra, Jovanovic Ivona Vranic, Stankovic Ivan
Clinical Hospital Centre Zemun, Department of Cardiology, Belgrade, Serbia.
Clinical Hospital Centre Zemun, Department of Cardiology, Belgrade, Serbia.
J Electrocardiol. 2025 Jul-Aug;91:154017. doi: 10.1016/j.jelectrocard.2025.154017. Epub 2025 May 6.
Electrocardiographic (ECG) indices, such as the morphology-voltage-P-wave (MVP) score, and echocardiographic parameters like left atrial volume index (LAVi), left atrial reservoir strain (LASr), and left atrial appendage (LAA) emptying velocity (LAAev) are associated with atrial fibrillation (AF) risk. However, the relationships between these markers remain incompletely understood.
This study aimed to investigate correlations between the ECG MVP score and echocardiographic indices of LA size and function.
In this prospective study, 60 patients in sinus rhythm, including 8 patients with paroxysmal AF, scheduled for transesophageal echocardiography underwent a 12‑lead ECG and transthoracic echocardiography within 30 min.
Significant correlations were observed between the mitral E/e' ratio and LAVi (r = 0.30, p = 0.029), LASr (r = -0.42, p = 0.002), and LAAev (r = -0.29, p = 0.037). In comparison to patients with mid-high MVP scores, LAAev was significantly lower in those with low MVP scores (49 ± 21 vs. 61 ± 23 cm/s, p = 0.027). No significant differences were observed between the groups in LAVi (40 ± 20 vs. 42 ± 12 ml/m, p = 0.187), LASr (26 ± 11 vs. 25 ± 10 %, p = 0.967), or mitral E/e' ratio (8.2 ± 1.6 vs. 7.3 ± 1.3, p = 0.876). Additionally, patients with paroxysmal AF had significantly lower LASr and higher mitral E/e' ratio compared to those without paroxysmal AF.
While LAVi, LASr, and LAAev were all related to noninvasively assessed left ventiricular (LV) filling pressure, only LAAev was able to differentiate risk categories based on the MVP score. Our findings suggest that a multiparametric approach to evaluating LA and LAA function, and LV filling pressures may offer a more comprehensive assessment of AF risk than using individual parameters.
心电图（ECG）指标，如形态-电压-P波（MVP）评分，以及超声心动图参数，如左心房容积指数（LAVi）、左心房储存应变（LASr）和左心耳（LAA）排空速度（LAAev），均与心房颤动（AF）风险相关。然而，这些标志物之间的关系仍未完全明确。
本研究旨在探讨心电图MVP评分与左心房大小和功能的超声心动图指标之间的相关性。
在这项前瞻性研究中，60例窦性心律患者，包括8例阵发性房颤患者，计划接受经食管超声心动图检查，在30分钟内进行了12导联心电图和经胸超声心动图检查。
二尖瓣E/e'比值与LAVi（r = 0.30，p = 0.029）、LASr（r = -0.42，p = 0.002）和LAAev（r = -0.29，p = 0.037）之间存在显著相关性。与中高MVP评分患者相比，低MVP评分患者的LAAev显著降低（49±21 vs. 61±23 cm/s，p = 0.027）。两组之间在LAVi（40±20 vs. 42±12 ml/m，p = 0.187）、LASr（26±11 vs. 25±10%，p = 0.967）或二尖瓣E/e'比值（8.2±1.6 vs. 7.3±1.3，p = 0.876）方面未观察到显著差异。此外，与无阵发性房颤的患者相比，阵发性房颤患者的LASr显著降低，二尖瓣E/e'比值显著升高。
结论：虽然LAVi、LASr和LAAev均与无创评估的左心室（LV）充盈压相关，但只有LAAev能够根据MVP评分区分风险类别。我们的研究结果表明，与使用单个参数相比，采用多参数方法评估左心房和左心耳功能以及左心室充盈压可能会对房颤风险提供更全面的评估。
