Quantitative Study Of Left Atrium Geometry Structure And Function In Patients With AF By 256-slice Spiral CT

Part one Quantitative study of left atrial geometry and function in non-valvular AF with 256-slice spiral CTObjective: 256-slice spiral CT was used to quantitatively measure the anatomical structure and function of the left atrium in patients with nonvalvular atrial fibrillation and sinus rhythm,and to analyze the geom etric structure and function changes of the left atrium in patients with atrial fibrillation and explore its clinical value.Methods: A total of 52 patients with atrial fibrillation who underwent coronary CTA scans were selected in our hospital(34 males and 18 females,with an average age of 55.54 ± 10.19 years)and 30 patients with sinus rhythm(15 males and 15 females,with an average age of 52.47± 10.36 years old)as a control group,the 10-phase reconstruction of the original CTA image was transmitted to the post-processing workstation.Measure the maximum of left atrium diameter(LADmax),the minimum of lef t atrium diameter(LADmin),the maximum longest diameter of the left atrium(Da),anterior volume of left atrium(LA-A),posterior volume of left atrium(LA-P);left atrial appendage volume(LAAV).Calculate the left atrial ejection fraction(LAEF),left atrial sphericity(LASP),and left atrial asymmetry index(ASI).The clinical data,geometric structure and function of the left atrium of the atrial fibrillation group and the control group were statistically analyzed.Results: 1.The height,weight,BMI,and BSA of patients in the atrial fibrill ation group were larger than those in the control group(P<0.05);2.LADmax,LADmin,LAVmax,LAVmin,and LAAV of the AF group were larger than those of the control group,and LAEF was smaller than the control group(P<0.05);3.The LA-A,LA-P,LASP,and ASI in the group were larger than those in the control group(P<0.05);4.There was no significant correlation between left atrial sphericity and gender,age,height,weight,BSA,Da,LAEF,and ASI.LASP and BMI(r=0.256,P=0.02),LADmax(r=0.525,P=0.000),LADmin(r=0.448,P=0.000),LAVmax(r=0.307,P=0.005),LAVmin(R=0.256,P=0.020),LA-A(r =0.271,P=0.014),and LA-P(r=0.357,P=0.001)were positive ly correlated;5.There was no significant correlation between the ASI and gender,age,height,weight,BMI,BSA,LADmax,LADmin,LA-P,LAEF,and ASI.ASI was positively correlated with Da(r=0.419,P=0.000),LAVm ax(r=0.378,P=0.000),LAVmin(r=0.297,P=0.007),and LA-A(r=0.525,P=0.000).Conclusions: Using 256-slice spiral CT to analyze and compare the structure and function of left atrium in patients with atrial fibrillation and patients with sinus rhythm.The left atrial geometric structure of patients with atrial fibrillation has remodeled,and atrial function has changed significantly.Part two Quantitative study of left atrial geometric remodeling and atrioventricular diastolic function in different types of atrial fibrillation by 256-slice spiral CTObjective: Quantitatively measure left atrial geometry,left atriumand ventricular function of paroxysmal(Pa AF)and persistent(Pe AF)atrial fibrillation by 256-slice spiral CT,and compare the left atrial remodeling and changes of left ventricular function in two different types of AF Characteristics,further explore its clinical value.Methods: A total of 143 patients with AF in our hospital were collected,including 112 patients with paroxysmal atrial fibrillation: 73 males and 39 females,with an average age of 60 ± 13.75 years.31 patients with persistent AF were: 18 males and 13 females.The average age was 62 ± 14.00 years old,and clinical data were recorded.Measure left atrial diameter of patients with AF: maximum diameter(LADmax),minimum diameter(LADmin);use left ventricular function software to measure left atrial volume: maximum volume(LAVmax)and minimum volume(LAVmin),Left atrium anterior volume(LA-A)and Left atrium posterior volume(LA-P);left atrial appendage volume(LAAV);Left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV).Calculate left atrial ejection fraction(LAEF),left ventricular ejection fraction(LVEF),and left atrial asymmetry index(ASI).Statistical analysis of clinical data,left atrial geometry,and left atrial and left ventricular function parameters were performed for the two groups.Results : 1.Comparison of clinical data between paroxysmal atrial fibrillation and persistent atrial fibrillation.Patients with persistent atrial fibrillation were more likely to have a history of heart failure(P=0.024).There was no statistical difference in the other indicators between the two groups.(P> 0.05);2.The LADmax,LADmin,LAAV,LA-A,and LA-P of the persistent atrial fibrillation group were all larger than those of the paroxysmal atrial fibrillation group(P<0.05),but there was no significant difference in ASI between the two groups(P> 0.05);3.LAVmax and LAVmin in the persistent atrial fibrillation group were larger than those in the paroxysmal atrial fibrillation group(P<0.05),while LAEF and LVEF were smaller than those in the paroxysmal atrial fibrillation group(P<0.05).Patients with paroxysmal atrial fibrillation have lower LVESV than patients with persistent atrial fibrillation.There was no significant difference in LVEDV between the two groups.4.There was no significant correlation between LASP and gender,age,height,weight,BSA,Da,LAEF,and ASI,BMI,LADmax,LADmin,LAVmax,LAVmin,LA-A,LA-P were positively correlated with LASP;5.There was no significant correlation between ASI and gender,age,height,weight,BMI,BSA,LADmax,LADmin,LA-P,LAEF,ASI.ASI with Da,LAVmax,LAVmin,LA-A were positively correlated.Conclusion:Quantitative measurement of left atrium and left ventricle in patients with different types of atrial fibrillation using 256-slice spiral CT can objectively reflect left atrial structural remodeling and left ventricular function.The left atrial geometric remodeling and changes in atrioventricular function in the persistent AF group were more obvious than those in the paroxysmal AF group.