Study On The Relationship Between Atrial Septal Aneurysm And Atrial Fibrillation In Adults

Objective: To evaluate the incidence of atrial septal aneurysm(ASA)by color Doppler echocardiography.Patients with atrial fibrillation(AF)in ASA patients were screened by electrocardiogram(ECG)to assess whether ASA patients were associated with the onset of atrial fibrillation(AF).Methods: 35 000 patients over 18 years old who underwent color Doppler echocardiography in our hospital from January 2013 to August 2018 were enrolled.All ASA patients diagnosed by color Doppler echocardiography were selected and the prevalence of ASA among the inpatients was calculated.The patients with ASA combined with AF were selected as the observation group.The patients without AF were selected as the control group during the same period.The related data were collected and analyzed.The prevalence rate of AF,age,sex distribution and the characteristics of cardiac color Doppler ultrasound were studied.Finally,the relationship between ASA and AF was evaluated.Results: The basic situation of the study population:(1)By observing the color Doppler echocardiography of 35 000 inpatients,875 ASA patients were found,307 males(35%)and568 females(65%).The prevalence of ASA in inpatients was 2.5%.According to excluding inclusion criteria,186 eligible ASA patients were collected.Among them,48 were ASA patients with AF,aged from 30 to 82 years,with an average age of(62.2 + 16.7)years,18 were males(37.5%)and 30 were females(62.5%).The prevalence of AF in ASA patients was25.8%.There were 138 cases with sinus rhythm in ASA.The age ranged from 18 to 84 years.The average age was(59.6 +12.98)years.Among them,43 cases were males(31.2%)and 95 cases were females(68.8%).2 test showed that the incidence of cerebral infarction in AF group was higher than that in sinus group(2 = 8.959,P = 0.03 < 0.05);age,sex,nationality,body mass index,systolic and diastolic blood pressure,hyperlipidemia,diabetes mellitus,coronary heart disease and hypertension had no difference between the two groups(P > 0.05)(table 1).(2)Cardiac color Doppler echocardiography data: There was significant difference in left atrial diameter between atrial fibrillation group and sinus group(P=0.000 < 0.01),that is,the left atrial diameter in atrial fibrillation group was significantly larger than that in sinus group;there was no difference in right atrial transverse diameter and right atrial upper and lower diameter between the two groups(P>0.05);there was no difference in ejection fraction between the two groups(P>0.05);there was significant difference in ASA bulge between the two groups(P<0.01),and ASA bulge in atrial fibrillat The basal diameter of ASA in the atrial fibrillation group was significantly larger than that in the sinus group(P=0.002<0.01).The basal diameter of ASA in the atrial fibrillation group was significantly larger than that in the sinus group.There was also a difference between the two groups(P= 0.016 < 0.05).The incidence of cerebral infarction in the atrial fibrillation group was higher than that in the sinus group.Diameter,end-diastolic thickness of interventricular septum,E/A ratio and FS were not significantly different(P > 0.05)(Table 2).(3)Atrial fibrillation group was divided into subgroups according to age < 60 years old and < 60 years old.The results showed that there was no difference in ASA bulge and basal diameter between the two groups(P > 0.05),that is,there was no age difference between ASA and AF at the two age stages(table 3).(4)According to the subgroup analysis of different types of atrial fibrillation,the ASA swelling and basal diameter,left atrial diameter in permanent AF group were the largest,persistent AF was the second,paroxysmal AF was the smallest,and there were significant differences among the three groups(P < 0.05)(Table 4).(5)Using age,sex,left atrial diameter,ASA bulge,ASA basal diameter,coronary heart disease and hypertension as covariates,andwhether AF occurs as dependent variables,binary logistic regression analysis showed that left atrial diameter was a risk factor for AF(OR = 1.638,P = 0.000 < 0.05,95% CL: 1.363-1.968);ASA bulge was a risk factor for AF(OR = 1.497,P = 0.042 < 0.05,95% CL: 1.968);and ASA bulge was a risk factor for AF(OR = 1.497,P = 0.042 < 0.05,95% CL: 1.01).5-2.209(table5).Conclusion:The prevalence rate of hospitalized ASA patients in this study was 2.5%.The incidence rate of AF in female patients was higher than that in male patients.The prevalence rate of AF in hospitalized ASA patients was 25.8%.Left atrial diameter and ASA bulge are independent risk factors of atrial fibrillation induced by ASA,and ASA bulge and basal diameter are important indicators of atrial fibrillation in ASA.