RT-3D Echocardiography And Three-plane Quantitative Tissue Velocity Imaging To Evaluate Left Atrial Function In Atrial Fibrillation

Objective:Real-time three-dimensional echocardiography(RT-3DE)combined with Three-plane quantitative tissue velocity imaging(QTVI)was used to evaluate the changes in the structure and function of the left atrium in patients with atrial fibrillation.Spontaneous imaging and thrombosis of the patients’ left atrium were predicted.Methods:Objects:Select 78 patients with confirmed atrial fibrillation:according to the diagnostic criteria of atrial fibrillation,they were divided into 46 cases of paroxysmal atrial fibrillation and 32 cases of persistent atrial fibrillation;according to the degree of mitral regurgitation,they were divided into 28 cases in the mild regurgitation group and 32 cases in the mild reflux group And 18 cases in the moderate reflux group.According to the presence or absence of spontaneous development,they were divided into 12 cases with spontaneous development and 66 cases without spontaneous development.Select 46 healthy volunteers as the control group.Measure conventional ultrasound parameters for all subjects;use three-plane QTVI to analyze and calculate the peak velocity of the six walls of the left atrium;use RT-3DE to measure LAVmax,LAVp and LAVmin.After standardization,LAVImax,LAVIp and LAVImin were obtained.Evaluate the left atrial function of patients with atrial fibrillation and atrial fibrillation with mitral regurgitation through various functional indicators of the left atrium;analyze the correlation between mitral regurgitation and the changes in left atrial structure and function;compare the left atrial function of patients with atrial fibrillation with and without spontaneous left atrium imaging and the feasibility of each functional parameter to predict the left atrium spontaneous imaging of patients with atrial fibrillation.Function indexes of left atrium:LAtEV,LApEV,LAaEV,LAEF,LApEF,LAaEF,LAFI and LAexpI。Results:1.Compared with those in the control group,LAD and E/Em in the atrial fibrillation were higher(P<0.05).In addition,the LAD in the persistent atrial fibrillation group was higher than that in the paroxysmal atrial fibrillation group(P<0.05).In contrast,Em and Am of paroxysmal atrial fibrillation group shows an adverse trend,with higher statistic than the control group(P<0.05).2.The three-dimensional volume parameters(LAVImax,LAVImin,LAVIp)of the left atrium in the atrial fibrillation group were significantly higher than those in the control group(P<0.05).LAVImax and LAVImin in the persistent atrial fibrillation group were higher than those in the paroxysmal atrial fibrillation group(P<0.05).LAtEF,LAFI and LAexpI in the atrial fibrillation group were significantly lower than those in the control group,and the persistent atrial fibrillation group was lower than the paroxysmal atrial fibrillation group(all P<0.05).LAaEV in paroxysmal atrial fibrillation group was higher than that in control group,while LAaEF was lower than control group(P<0.05).3.Compared with LAVs and LAVa of the control group,those of the atrial fibrillation group were much lower,and the persistent atrial fibrillation group was lower than the paroxysmal atrial fibrillation group(both P<0.05);Furthermore,LAVe in the persistent atrial fibrillation group was lower than that in the paroxysmal atrial fibrillation group and the control group(P<0.05).4.The LAD of the atrial fibrillation combined with mild reflux group and moderate reflux group was higher than that of the sub-mild reflux group(P<0.05).LAexpI,LAFI,LAVs,LAVe,LAVa were all lower than the sub-mild reflux group(All P<0.05),and the LAD of the moderate reflux group was higher than that of the mild reflux group,LAexpI,LAFI,LA Vs and LAVa were lower than the mild reflux group(all P<0.05).5.The mitral regurgitation volume is correlated with left atrial structure and function parameters(P<0.05),positively correlated with LAD,and the correlation coefficient is(r=0.778),and negatively correlated with LAFI,LAVs,LAVe,and LAVa.The coefficients are(r=-0.922,r=-0.858,r=-0.944,r=-0.931).6.In the atrial fibrillation group,the LAD and LAVImax of the left atrium(ear)with spontaneous imaging were higher than those without spontaneous imaging(P<0.05);LAtEF and left atrium wall motion speeds LAVs,LAVe,LAVa were lower than those without spontaneous imaging(P<0.05).The measured values of LAVImax,LAtEF and three-plane QTVI have predictive value for spontaneous imaging of the left atrium,and the best cut-off values are:42.5ml/m2,38.5%,4.1cm/s,respectively.Conclusion:RT-3DE combined with tri-plane QTVI can simply,objectively and non-invasively evaluate the changes in left atrial structure and function in patients with atrial fibrillation and atrial fibrillation combined with mitral regurgitation,and the combination of the two can more comprehensively evaluate left atrial function.The prediction of the spontaneous imaging of the left atrium by RT-3DE and tri-plane QTVI measurement parameters can guide the early clinical anticoagulation therapy to prevent the formation and shedding of thrombus.