Novel algorithm for non-invasive estimation of left atrial pressure in patients with atrial fibrillation.

IF 6.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jiwon Seo, Hee Tae Yu, In-Soo Kim, Tae-Hoon Kim, Boyoung Joung, Hui-Nam Pak, Iksung Cho, Chi Young Shim, Geu-Ru Hong, Jong-Won Ha
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引用次数: 0

Abstract

Aims: Determining elevated left atrial (LA) pressure is crucial in patients with atrial fibrillation (AF), yet non-invasive estimation using echocardiography remains unclear. This study aimed to identify useful echocardiographic indices for identifying elevated LA pressure in patients with AF.

Methods and results: Patients with paroxysmal or persistent AF referred for catheter ablation at two tertiary hospitals were prospectively enrolled. Mean LA pressure was measured immediately after transseptal puncture. Elevated mean LA pressure was defined as ≥15 mmHg. Transthoracic echocardiography was performed to acquire the guideline-recommended parameters. A total of 176 patients were included, and 63 (36%) patients had a mean LA pressure ≥15 mmHg. Patients with elevated LA pressure had more frequent hypertension, larger LA, higher septal E/e', and worse LA strain than the remaining patients. The correlations between mean LA pressure and each echocardiographic parameter were weak. Septal E/e' ratio showed the best correlation with mean LA pressure (r = 0.351, P < 0.001), and septal E/e' ratio ≥11 was the best parameter (area under the curve = 0.7, sensitivity = 65%, specificity = 73%, accuracy = 70%) to identify elevated mean LA pressure. A hierarchical algorithm consisting of septal E/e' ratio, LA reservoir strain, and LA volume index improved identification of patients with elevated mean LA pressure (sensitivity = 61%, specificity = 91%, accuracy = 80%).

Conclusion: In patients with AF, the septal E/e' ratio was the best single parameter for identifying elevated mean LA pressure. A hierarchical algorithm combining the septal E/e' ratio, LA reservoir strain, and LA volume index helps identify elevated LA pressure in patients with AF.

心房颤动患者左房压无创评估的新算法。
目的:确定心房颤动(AF)患者左房(LA)压力升高是至关重要的,但使用超声心动图无创评估仍不清楚。本研究旨在确定超声心动图指标用于识别房颤患者的左室压升高。方法和结果:前瞻性纳入两家三级医院的阵发性或持续性房颤患者行导管消融治疗。经间隔穿刺后立即测量平均LA压。平均LA压升高定义为≥15 mmHg。经胸超声心动图获得指南推荐的参数。共纳入176例患者,其中63例(36%)患者平均LA压≥15 mmHg。与其他患者相比,LA压升高的患者高血压发生率更高,LA更大,间隔E/ E′更高,LA应变更差。平均左室压与超声心动图各参数相关性较弱。间隔E/ E′比与平均LA压相关性最好(r = 0.351, P < 0.001),且间隔E/ E′比≥11是鉴别平均LA压升高的最佳参数(曲线下面积= 0.7,敏感性= 65%,特异性= 73%,准确性= 70%)。由间隔E/ E比值、LA库应变和LA容积指数组成的分层算法提高了对平均LA压升高患者的识别(灵敏度为61%,特异性为91%,准确性为80%)。结论:在房颤患者中,间隔E/ E比值是识别平均LA压升高的最佳单一参数。结合间隔E/ E比值、左室储层应变和左室容积指数的分层算法有助于识别房颤患者的左室压升高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Heart Journal - Cardiovascular Imaging
European Heart Journal - Cardiovascular Imaging CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
9.70%
发文量
708
审稿时长
4-8 weeks
期刊介绍: European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology. The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.
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