Evaluation Of Right Atrial Function In Patients With Chronic Atrial Fibrillation By Real-time Three-dimensional Echocardiography

Purpose:Two-dimensional and real-time three-dimensional echocardiography(RT-3DE)was used to evaluate the changes of right atrial structure and function in patients with chronic atrial fibrillation(AF).By studying the influence of chronic AF on right atrial structure and function,it can better assist AF patients in the formulation of clinical diagnosis and treatment strategies and the judgment of prognosis,and discuss the clinical application value of RT-3DE in AF.Methods:According to the inclusion and exclusion criteria,30 AF patients were selected from January 2018 to December 2019 who were admitted to the outpatient department of cardiology or hospitalized in the 940 hospital of the joint logistic support force(hereinafter referred to as our hospital).General information was collected,including gender,age,height,weight,body mass index(BMI),body surface area(BSA),hypertension history,systolic blood pressure,diastolic blood pressure and heart rate.Of conventional index through two-dimensional echocardiography and right atrial function index to measure,conventional indicators including left ventricular ejection fraction(LVEF),the thickness of interventricular septum(IVS),left ventricular posterior wall thickness(LVPW),right atrial function index around the end of the right atrial diastolic diameter(RAD1),up and down at the end of the right atrial diastolic diameter(RAD2),application of binary Logistic regression analysis which parameters are the risk factors influencing the AF occurred;RT-3DE was used to obtain the right atrial end-diastolic volume(Vmax),the right atrial end-systolic volume(Vmin),and the right atrial pre-active systolic volume(Vpre),and the mean value of the measurements was obtained three times.Right atrial storage function parameters:right atrial ejection volume(SV),right atrial ejection fraction(EF),right atrial duct function parameters are:passive right atrial ejection volume(SVpas),passive right atrial ejection fraction(EFpas),right atrial booster pump function parameters are:active right atrial ejection volume(SVact),active right atrial ejection fraction(EFact).After the calculation of body surface area correction,the corresponding volume index of the right atrium was obtained,namely VImax,VImin,VIpre,SVI,SVIpas,SVIact,EF,EFpas,EFact.Data analysis was carried out on the two groups to evaluate the changes of right atrial function.Results:Compared with the control group,there were no statistically significant differences in gender,BMI,BSA,systolic blood pressure,diastolic blood pressure and heart rate in the case group(p>0.05).Compared with the control group,there were statistically significant differences in age and history of hypertension in the case group(p<0.05),and the age(60.77±5.91 vs56.47±6.70)years old and incidence of hypertension(36.7%vs 13.3%)in the case group were higher than those in the control group.In this study,binary Logistic regression analysis showed that RADI1(OR=0.05,95%CI0.00-0.77),RADI2(OR=35.45,95%CI 3.27-383.78)could be used as risk factors for AF.Conventional two-dimensional ultrasonic measurement results:compared with the control group,there were no statistically significant differences in IVS,LVPW and LV EF in the case group(p>0.05),and the differences were statistically significant in RADI1(24.66±2.36 vs 20.94±1.67)mm/m~2 and RADI2(30.84±2.90 vs 24.85±2.03)mm/m~2(p<0.05).Measurement results of 3D ultrasonic parameters:compared with the control grou-p,VImax(27.28±2.67 vs 21.93±2.62)ml/m~2,VImin(15.07±1.82 vs 11.27±1.81)ml/m~2,VIpre(18.16±2.08 vs 13.63±2.16)ml/m~2,SVI(12.21±1.05 vs 10.65±0.91)ml/m~2,SVIpas(9.11±0.71 vs 8.30±0.58)ml/m~2,SVIact(3.09±0.37 vs 2.35±0.37)ml/m~2 in the case gr-oup increased,EF(26%vs 29%),EFpas(20%vs 22%),EFact(9%vs 10%)in the case group decreased,with statistically significant differences(p<0.05).Conclusion:According to the results of this study,with the increase of age and the occurrence of hypertension,the incidence of AF is on the rise.RADI1 and RADI2 can be used as risk factors for the occurrence of AF.AF has a negative effect on the functions of right atrial storage,pipelines and booster pumps,and the overall ejection,passive and active ejection functions are weakened.RT-3DE is independent of the geometry of the right atrium and can accurately and intuitively measure the volume and ejection fraction of the right atrium.