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基于三维斑点追踪成像技术评价高海拔地区心房颤动患者左心房结构和功能的变化

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摘要:

目的 探究基于三维斑点追踪成像(3D-STI)技术评价高海拔地区心房颤动(AF)患者
左心房结构和功能的变化。方法 回顾性分析2017年1月至2020年12月于青海省心脑血管病专科医院收
治的AF导管消融手术的高海拔地区AF患者249例,按AF类型分为阵发组(阵发性AF,n=116)和持续
组(持续性AF,n=133),另选取同期我院健康体检者105例为对照组。采用3D-STI技术检测各组患者
左房储存功能(LAVImax,LAVImin)、管道功能(LAVIp,LAPEF)、辅泵功能(LAVIa,LAAEF)、
整体应变(GRS,GLS,GCS,GAS)参数,计算左房僵硬度(LASt),分析LASt与3D-STI相关参数关
系。结果 持续组LAVImax、LAVImin、LASt高于阵发组和对照组,且阵发组高于对照组(P<0.05),持
续组LATEF、LAEI、GLS、GCS、GRS、GAS低于阵发组和对照组,且阵发组低于对照组(P<0.05),
持续组、阵发组LAVIa高于对照组,LAVIp、LAAEF、LAPEF低于对照组(P<0.05);Pearson相关性
分析显示,LASt与LAVImax、LAVImin呈正相关(r=0.408、r=0.534,P<0.001),与LATEF、LAEI、
GRS、GLS、GCS、GAS呈负相关(r=-0.416、r=-0.427、r=-0.502、r=-0.379、r=-0.420、r=-0.363,P
<0.001)。结论 高海拔地区AF患者左房僵硬度增加,储存、管道、辅泵功能及应变降低,左房僵硬度
与其功能及应变有关,运用3D-STI技术能有效评价AF患者左心房结构和功能变化。

Abstract:

Objective To study the changes of left atrial structure and function reviewed based on threedimensional speckle tracking imaging (3D-STI) in patients with atrial fibrillation (AF) in high altitude areas. Methods AF patients (n=249) in high altitude areas undergone catheter ablation were retrospective analyzed from Qinghai Provincial Special Hospital of Cardiovascular and Cerebrovascular Diseases from Jan. 2017 to Dec. 2020. All patients were divided, according to AF types, into paroxysmal atrial fibrillation group (PAF group, n=116) and persistent atrial fibrillation group (PeAF group, n=133). Another healthy controls (n=105) were chosen into control group. The parameters of left atrial storage function (LAVImax, LAVImin), left atrial duct function (LAVIp, LAPEF), left atrialauxiliary pump function (LAVIa, LAAEF) and left atrial global strain (GRS, GLS, GCS, GAS) were detected by using 3D-STI technique, left atrial stiffness (LASt) was calculated, and relationship between LASt and 3D-STI parameters were analyzed. Results LAVImax, LAVImin and LASt were higher in PeAF group than those in PAF group, and they were higher in PAF group than those in control group (P<0.05). LATEF, LAEI, GLS, GCS, GRS and GAS were lower in PeAF group than those in PAF group and control group, and they were lower in PAF group than those in control group (P<0.05). LAVIa was higher, and LAVIp, LAAEF and LAPEF were lower in PeAF group and PAF group than those in control group (P<0.05). The results of Pearson correlation analysis showed that LASt was positively correlated to LAVImax and LAVImin (r=0.408, r=0.534, P<0.001), and negatively correlated to LATEF, LAEI, GRS, GLS, GCS and GAS (r=-0.416, r=-0.427, r=-0.502, r=-0.379, r=-0.420, r=-0.363, P<0.001). Conclusion LASt increases, and left atrial storage, duct, auxiliary pump and strain decrease in AF patients in high altitude areas. LASt is correlated to left atrial function and strain. 3D-STI technique can effectively review the changes of left atrial structure and function in AF patients.

基金项目:

青海省科学技术厅课(9632021Y0147)

参考文献:

  • 2008

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