■房颤(AF)患者出现左心房(LA)下劳损,这是LA函数的预测器。这里,我们评估了LA应变的预后价值,以预测持续性房颤患者接受LA冷冻消融术同时接受微创二尖瓣修复的心律结局.
■在2016年1月至2020年12月之间,有72例持续性房颤患者在微创二尖瓣手术中接受了LA冷冻消融术。所有患者均接受完整的LA病变组,并用夹子闭合左心耳(LAA)。所有患者均接受术前经胸超声心动图(TTE),并进行LA和左心室应变测量。术前LA和LV应变分析与术后节律结果相关。
■患者的平均年龄为66.9±7.2岁,其中42名(58%)为男性患者。所有患者均未发生与消融相关的重大并发症。所有患者术中超声心动图均证实LAA闭合成功。1年生存率为97%。12个月时房颤的发生率为72%,抗心律失常药物的发生率为68%。在随访12个月时,无房颤患者的术前LA应变值在统计学上明显更高(12.7%±6.9%vs.4.9%±4.1%,p=0.006)。术前LV应变值与术后节律结果无关。在多变量逻辑回归分析中,在随访12个月时,LA应变(p<0.001)和AF持续时间(p=0.017)是无AF的预测因子。
■在我们的研究中,LA应变分析可预测持续性房颤患者同时接受外科房颤消融术的节律结果。在未来,LA应变可能是指导持续性房颤患者消融策略决策的有用工具。
UNASSIGNED: Patients with atrial fibrillation (AF) have lower left atrial (LA) strain, which is a predictor for LA function. Here, we evaluated the prognostic value of LA strain to predict the rhythm outcome in patients with persistent AF undergoing LA cryoablation concomitant to minimally invasive mitral valve repair.
UNASSIGNED: Between 01/2016 and 12/2020, 72 patients with persistent AF underwent LA cryoablation during minimally invasive mitral valve surgery. All patients received a complete LA lesion set and left atrial appendage (LAA) closure with a clip. All patients received preoperative transthoracic echocardiography (TTE) with LA and left ventricular strain measurements. Preoperative LA and LV strain analysis was correlated with postoperative rhythm outcome.
UNASSIGNED: The mean age of the patients was 66.9 ± 7.2 years, of whom 42 (58%) were male patients. No major ablation-related complications occurred in any of the patients. Successful LAA closure was confirmed by intraoperative echocardiography in all patients. The 1-year survival rate was 97%. Freedom from AF at 12 months was 72% and 68% off antiarrhythmic drugs. Preoperative LA strain values were statistically significantly higher in patients with freedom from AF at 12 months of follow-up (12.7% ± 6.9% vs. 4.9% ± 4.1%, p = 0.006). Preoperative LV strain value was not associated with postoperative rhythm outcome. In multivariate logistic regression analysis, LA strain (p < 0.001) and AF duration (p = 0.017) were predictors for freedom from AF at 12 months of follow-up.
UNASSIGNED: In our study, LA strain analysis predicted the rhythm outcome in patients with persistent AF undergoing concomitant surgical AF ablation. In the future, LA strain might be a useful tool to guide decision-making on ablation strategies in patients with persistent AF.