Zhang Qi, Liu Nan Nan, Sun Jing Shu, Wang Zu Lu, Liang Ming, Li Gui Shen, Wang Mei Yi
Department of Cardiology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang, 110016, China.
Sci Rep. 2025 Aug 2;15(1):28209. doi: 10.1038/s41598-025-12908-5.
To evaluate dynamic changes in left atrial (LA) structure and function after catheter ablation in paroxysmal atrial fibrillation (PAF) patients with preserved ejection fraction using conventional echocardiography and 2D speckle-tracking imaging (2D-STI). Eighty-nine PAF patients underwent echocardiography at 48 h pre-ablation, 1-day, 1-month, and 3-month post-ablation. Parameters included LA diameter (LAD), volume index (LAVI), strain (left atrial systolic strain (LASRs), early left atrial diastolic strain (LASRe), late left atrial diastolic strain (LASRa), and stiffness (LASt). At 1 day post-ablation, left ventricular ejection fraction (LVEF), peak early LA diastolic strain (LASRe), peak late LA diastolic strain (LASRa), and their strain rates were lower than baseline, while LA ejection fraction (LAEF) was higher (all P < 0.05). At 1 month and 3 months post-ablation, LA diameter (LAD), end-systolic/diastolic volumes, and volume index (LAVI) were significantly reduced, while left atrial appendage flow velocity (LAA-V), LAEF, LVEF, peak LA systolic strain (LASRs), and related strain rates were increased (all P < 0.05). Cox regression analysis showed that the 1-month LASRs recovery rate (ΔLASRs) was an independent predictor of AF recurrence (hazard ratio = 0.72, 95% confidence interval: 0.54-0.96, P = 0.023). After catheter ablation, LA reverse remodeling exhibits a pattern of "functional recovery preceding structural recovery". The improvement in functional parameters at 1 month post-ablation is of significant value for predicting long-term prognosis.
使用传统超声心动图和二维斑点追踪成像(2D-STI)评估射血分数保留的阵发性心房颤动(PAF)患者导管消融术后左心房(LA)结构和功能的动态变化。89例PAF患者在消融术前48小时、消融术后1天、1个月和3个月接受超声心动图检查。参数包括左心房直径(LAD)、容积指数(LAVI)、应变(左心房收缩期应变(LASRs)、左心房舒张早期应变(LASRe)、左心房舒张晚期应变(LASRa))和硬度(LASt)。消融术后1天,左心室射血分数(LVEF)、左心房舒张早期峰值应变(LASRe)、左心房舒张晚期峰值应变(LASRa)及其应变率低于基线,而左心房射血分数(LAEF)较高(均P<0.05)。消融术后1个月和3个月,左心房直径(LAD)、收缩末期/舒张末期容积和容积指数(LAVI)显著减小,而左心耳流速(LAA-V)、LAEF、LVEF、左心房收缩期峰值应变(LASRs)及相关应变率增加(均P<0.05)。Cox回归分析显示,1个月时LASRs恢复率(ΔLASRs)是房颤复发的独立预测因素(风险比=0.72,95%置信区间:0.54-0.96,P=0.023)。导管消融术后,左心房逆向重构呈现“功能恢复先于结构恢复”的模式。消融术后1个月功能参数的改善对预测长期预后具有重要价值。