摘要
目的应用超声定量分析技术测量心房颤动（简称房颤）患者射频消融术（RFCA）后左房结构及功能，评价其对术后复发的预测价值。方法行RFCA的阵发性及持续性房颤患者102例，健康对照组22例。测量左室舒张早期左房应变（Se）、左房总应变（Sg），舒张晚期左房应变（Sa）、舒张早期应变率（SRe）、舒张晚期应变率（SRa）、收缩期应变率（SRs）；计算应变达峰时间标准差（TPSe-SD，TPSg—SD）和应变率达峰时间标准差（TPSRe—SD，TPSRa—SD，TPSRs—SD）；测量左房最大容积（LAVmax）、左房最小容积（LAVmin），计算左房总排空容积（LASV）、左房射血分数（LAEF）。使用二元Logistic回归分析得到回归方程，选取SPSS工作表中产生的个体预测概率变量绘制多变量ROC曲线，确定曲线下面积（areaundercurve，AUC）及最佳截断点。结果阵发性房颤组：复发患者Sg及Se、Em减低，TPSRe-SD、TPSR〉SD增大（均P〈0．05），Logistic回归方程为P=1／[1＋e^-（3.994＋0.22×Se＋0.115×Sg＋0.04×TPSRe-SD-0.354×Em＋0.02×TPSRsSD）]，以P≥0．202为截值预测复发的敏感性和特异性最高，分别为88．9％和89．4％；持续性房颤组：复发患者SRs，LAEF及LASV减低，E／Em增大（均P〈0．05）；Logistic回归方程为P=1／[1＋e^-（1.139-0.102LASV＋0.348×E/Em-3.266×LAEF-0.417×SRs）]，以P≥0．502为截值预测复发的敏感性和特异性最高，分别为77．3％和79．2％。结论左房超声定量分析技术对房颤消融术后复发有很好的预测价值。阵发性房颤患者可通过应变及应变率达峰时间标准差预测复发，持续性房颤患者可通过LASV、LAEF、SRs预测复发，多指标联合预测价值更高。
Objective To evaluate the predictive value of radiofrequency catheter ablation （RFCA） in patients with atrial fibrillation by measuring the left atrial structure and functional parameters with quantitative eehocardiography. Methods One hundred and two patients with atrial fibrillation underwent radiofrequency ablation and 22 healthy cases as control group were enrolled in this study. Early diastolic strain（Se）, global diastolic strain（Sg）, late diastolic strain （ Sa = Sg - Se）, early diastolic strain rate （SRe）, late diastolic strain rate（SRa）, systolic strain rate （SRs） were measured. The standard deviations were calculated by time to peak of strain and strain rate. Left atrial maximum volume （LAVmax） and left atrial minimum volume （LAVmin） were measured. Left atrial stroke volume （LASV） and left atrial ejection fraction （LAEF） were calculated. The regression equation was obtained by binary logistic regression analysis. The individual probabilistic variables generated in the SPSS worksheet were selected to plot the multivariate ROC curve to determine the area undercurve （AUC） and the optimal cutoff point. Results In the group of paroxysmal atrial fibrillation： Sg, Se, Em decreased and TPSR-SD, TPSRs-SD increased significantly （P 〈0.05） in the relapsed patients; The logistic regression equation was P = 1/[1＋e^-（3.994＋0.22×Se＋0.115×Sg＋0.04×TPSRe-SD-0.354×Em＋0.02×TPSRsSD）]. With P〈0.202 as thecut-off, the sensitivity and specificity of recurrence were the highest, 88.9% and 89.4% respectively. In the group of persistent atrial fibrillation：the SRs, LAEF and LASV decreased and E/Em increased （ P d0.05 ） in the relapsed patients. The logistic regression equation was P = 1/[1＋e^-（1.139-0.102LASV＋0.348×E/Em-3.266×LAEF-0.417×SRs）], With P〈0.502 as thecut-off, the sensitivity and specificity of recurrence were the highest, 77.3% and 79.2% respectively. Conclusions Left atrial ultrasound quantitative analysis techniques to atri
出处
《中华超声影像学杂志》
CSCD
北大核心
2017年第8期650-656,共7页
Chinese Journal of Ultrasonography
关键词
超声心动描记术
心房颤动
射频消融术
二维斑点追踪成像
应变
Echocardiograhy
Atrial fibrillation
Radiofrequency ablation
Two-dimensional speckle tracking imaging
Strain
