To Assess Right Atrial Function In Patients With Paroxysmal Atrial Fibrillation By Three-dimensional Echocardiography And Two-dimensional Speckle Tracking Echocardiography

Objective:To assess Right Atrial(RA)Function in Patients with paroxysmal atrial fibrillation by Two-dimensional Speckle Tracking Echocardiography(2D-STE)and Three-dimensional Echocardiography(3DE).Methods:In the patient group,30 patients with paroxysmal atrial fibrillation(PAF)admitted to the department of cardiology of our hospital from October 2017 to September 2018,including 17 males and 13 females,aged 57 to 73 years old,with an average age of 68.7±5.6 years,all patients were admitted to the hospital with an electrocardiogram confirming the onset of atrial fibrillation,and in the sinus rhythm during echocardiography,and any other systemic diseases were excluded.In order to avoid the influence of age factors,the control group included 30 healthy volunteers of the same age group who came to our hospital for physical examination in the same period,including 14 males and 16 females,aged 54~71 years,with an average age of 63.5±5.6years.In the control group,laboratory test,electrocardiogram,chest X-ray,echocardiography and blood laboratory test indexes were all normal and without genetic disorders and chronic disease.Philips EPIC 7C doppler ultrasound diagnostic instrument was used as the measuring instrument.The probe X5-1(frequency of 1-5MHz)was used for off-line analysis with QLab software of Philips' after data storage.Measurement indicators include:1.Conventional parameter measurement: gender,age,heart rate,height and weight of subjects were recorded and the ultrasonic instrument automatically generates the body surface area.All subjects were instructed to take left lateral position or horizontal position and breathe calmly.Conventional transthoracic echocardiography was performed on two group of subjects to complete two-dimensional image collection and required parameter measurement.The parameters of the conventional echocardiography respectively:Right atria short axis diameter(RAS),right atria long axis diameter(RAL),peak velocity of the tricuspid valve early diastolic filling wave(TVE),peak velocity of the tricuspid valve late diastolic filling wave(TVA),tricuspid annular early diastolic filling velocity(TVe'),tricuspid annular late diastolic filling velocity(TVa').2.Right heart parameter measurement:(1)2D-STE:Right atria peak strain rate of systole(SRs),right atria peak strain rate of early diastole(SRe),right atria peak strain rate of late diastole(SRa).(2)3DE:Maximum right atrial volume(RAVmax),minimum right atrial volume(RAVmin),right atrial presystolic volume(RAVpre).The parameters were standardized by body surface area(BSA).Volume index in every stage were calculated:Maximum right atrial volume index(RAVImax),minimum right atrial volume index(RAVImin)and right atrial presystolic volume index(RAVIpre).And right atrial active ejection fraction(act EF),=(RAVp-RAVmin)/ RAVmax,Right atrial passive ejection fraction,pas EF)=(RAVmax-RAVpre)/RAVmax?Results:1.Conventional measurement:Compared with the control group,there was no significant difference in each index between the patient group and the control group.(all P<0.05).2.2D-STE:Compared with the control group,SRs,SRe and SRa were decreased in the patient group,and there were significant differences(all P<0.05).3.3DE:Compared with the control group,RAVImax,RAVImin and RAVIpre in the patient group increased,while pas EF and act EF decreased and there were significant differences(all P<0.05).Conclusions:The right atrial pipeline function,reserve function and pump function and of PAF patients are decreased.2D-STE and 3DE could assess the right atrial function effectively.