| Objective: By measuring the left atrial volume index of the enlargement in patientswith left atrium, to discuss the point of atrial fibrillation by left atrial remodelinginducing，in order to evaluate left atrial volume index in prognostic value in patients withatrial fibrillation，to provide a new evaluation index to prevent atrial fibrillation inpatients with real cardiac remodeling.Methods： Study of178routine ultrasound heartbeat graph examination ofoutpatients，103males,75females，the age was from35to89years old, average age63.3±9.5years. The inclusion criteria：Patients with left atrial enlargement（LAD≥40cmas the increase of left atrium）, Exclusion criteria: the right atrial enlargement patients byvalvular heart disease, increasing pulmonary artery pressure leading. All patients wererecorded the standard Apical four chamber and two chamber heart2DE image, Allpatients using the double plane Simpson ’s method for off-line inspection to test1eftAtrial volume, All subjects underwent standard12-lead electrocardiogram, and measureheight, weight. All the cases according to the ECG automatic were divided into twogroups, atrial fibrillation group and non-atrial fibrillation group: atrial fibrillation group63cases，non-atrial fibrillation group115cases. All based on the latest recommendedrecommended in the Guide for the ASE left atrial size measured by LAVI, left atrialvolume (1eft Atrial volume,LAV) and body surface area (body surface area,BSA) ratio,the formula is LAVI=LAV/BSA. Compared with LAVI of atrial fibrillation group andnon-atrial fibrillation group, and have the correlation analysis; the use ofechocardiographic measurement of left atrial volume index as a predictive diagnostic test, blind comparison, synchronization, calculate the forecast sensitivity, Sensitivity andspecificity of the diagnostic tests, and draw a ROC curve, and use the correct diagnosticindicators to accurately evaluate the diagnostic value of the indicator.Results:1.AF group and non-AF group on gender, age, risk factors for atrialfibrillation (smoking, drinking), and associated with the underlying disease (coronaryheart disease, diabetes, high blood pressure, rheumatic), the differences are notstatistically significant (p>O.05), atrial fibrillation among groups with a non-af leftventricular end diastolic volume (LVEDV), left ventricular end diastolic volume(LVESV), left ventricular ejection fraction (LVEF) differences are not statisticallysignificant (P>O,05) and left atrial volume index (LAVI) there has been a markeddifference statistically significant (P<0.01).2. LAVI ROC curve in diagnosis of atrialfibrillation can be relatively straightforward to identify critical points, also prompted thediagnosis of authenticity is high.3. Through this pilot study can make a LAVI tries topredict the ideal point for atrial fibrillation is40ml/m2.Conclusion:1. LAVI assess the rate of atrial fibrillation is feasible, also is a accurateindicator of the prediction of occurrence rate in patients with atrial fibrillation.2.. ROCcurve and the correct diagnosis index results suggest: The value of LAVI in the diagnosisof atrial fibrillation is higher.3. Through this pilot study can make a LAVI tries to predictthe ideal point for atrial fibrillation is40ml/m2.4. The experimental studies have shownthat, LAVI can reflect the left atrial size, predict the incidence of atrial fibrillation and itsoperation is simple, non-invasive, should play an important role in clinical practice.6.Although the experiment obtain this conclusion,but the occurrence of atrial fibrillationunder the influence of many factors, not only by LAVI to diagnose its incidence, inconjunction with clinical and other indicators to consider. |
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