Evaluation Of Heart Function And Treatment In Patients With Atrial Fibrillation By Echocardiography

Objective:To evaluate the left ventricular(LV) diastolic function, left ventricular systolic function and left atrial(LA) function in patients with atrial fibrillation(AF) with echocardiography. To evaluate the changes of LV function and LA function in patients with AF after radiofrequency catheter ablation (RFCA) or drug treatment using echocardiography.Methods:1.The patients were divided into the group with AF(n=35) and the group with sinus rhythm(n=30). No patients with significant dyskinetic cardiac chamber, systolic dysfunction of LV, valve disease or regional wall motion abnormality were included. Parameters derived from the routine 2D ultrasound, transmittal flow spectral, color M-mode, tissue velocity imaging (TVI) and strain imaging were acquired in the group with AF and compared with the group with sinus rhythm.2. (1) The paroxysmal AF and persistent AF patients were divided into the group with RFCA (n=35) and the group with drug treatment (n=35). (2)The chronic AF patients were divided into the group with RFCA (n=20) and the group with drug treatment (n=25).No patients with significant dyskinetic cardiac chamber, systolic dysfunction of LV, valve disease or regional wall motion abnormality were included. Parameters derived from the color M-mode, TVI and strain imaging were acquired in the patients with AF before RFCA or drug treatment.Parameters included the LV early diastolic flow propagation velocity(VP),the peak velocity of mitral ring in the early diastolic phase (Em), the peak velocity of lateral wall in the systolic phase (Vs) and the peak strain of LA.All patients received echocardiography examinations in 6 months after RFCA or drug treatment.Results:1.In AF patients, VP, Em, Vs and the peak strain of LA were significantly decreased than those of the patients with sinus rhythm (p< 0.05), the mitral inflow velocity in early diastolic phase/Em (E/Em) was significantly increased (p< 0.01).2. (1)After a mean follow-up of 6 months,91.43%(32/35)patients in group of paroxysmal AF and persistent AF with RFCA had no recurrence of AF, compared with 68.57%(24/35) in group of paroxysmal AF and persistent AF with drug treatment.(2)In all groups with RFCA or drug treatment, the VP, Em, Vs and the peak strain of LA were significantly increased compared with pre-therapy (p<0.05).(3)There was significant difference in LV function and LA function between two groups with paroxysmal AF and persistent AF (p<0.05). Compared with the drug treatment group between pre-and post-therapy,the increase of VP, Em, Vs and the peak strain of LA in RFCA group were more significant in statistics(p<0.05). There was significant difference in LV function and LA function between two groups with chronic AF (p<0.05). Compared with the chronic AF group with drug treatment between pre-and post-therapy,the increase of VP, Em, Vs and the peak strain of LA in the chronic AF group with RFCA were more significant in statistics(p<0.05). Conclusion:(1)There are diastolic(and systolic) dysfunction of LV and dysfunction of LA in the group with AF compared with the sinus rhythm group when cardiac structure have not changed significantly. (2)Parameters derived from the transmittal flow spectral, color M-mode, TVI and strain imaging can quantify the LV and LA fuction in AF patients accurately and quantificationally. (3)In patients with AF,medicine and RFCA treatment can improve the LV diastolic function, LV systolic function and LA function,the result in RFCA group was much better than drug treatment group.(4)RFCA has Higher rate of converting AF than drug treatment.