房颤患者三维左心房应变分析用于卒中风险评估：有和无卒中史患者的比较

IF 2.4 3区医学 Q3 BIOPHYSICS

Journal of biomechanics Pub Date : 2025-09-27 DOI:10.1016/j.jbiomech.2025.112981

Han Yu , Hujin Xie , Zidun Wang , Hao Wu , Arnold Ng , William Wang , Zhengduo Zhu , Jiaqiu Wang , Runxin Fang , Ruoyan Meng , Haotong Xu , Shanglin Wu , Haveena Anbananthan , Minghao Liu , Zhiyong Li

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引用次数: 0

摘要

心房颤动（AF）患者有发生心脏栓塞性中风的危险。最近的研究表明，减少二维左心房（LA）变形，如纵向应变，可能是卒中风险的潜在指标。我们的目的是评估持续性房颤患者的三维（3-D） LA全局和局部应变，并比较有和没有心脏栓塞性卒中史的患者。22例持续性心房颤动患者（其中11例为心脏栓塞性卒中）纳入本研究。采用网格正则化子体积跟踪方法计算了LA应变。分析了8个LA区域（前、外侧、附肢、顶、后、二尖瓣峡、底和中隔）的LA形态、CHADS-VASC2和3-D全局和局部应变。为了探索所收集的参数在卒中风险评估中的潜在性能，我们使用逻辑回归来评估使用这些参数识别心源性卒中患者的结果。与没有卒中事件的患者相比，心栓塞性卒中患者整体应变较低（0.090 vs 0.101; p = 0.006）。心源性卒中患者在顶部（0.087 vs 0.106, p = 0.030）、后部（0.055 vs 0.072, p < 0.001）和底部（0.083 vs 0.097, p = 0.022）的应变值也较低。logistic回归结果表明，LA后应变作为既往脑卒中事件指标的准确性为0.8958。因此，3-D LA整体和局部应变（特别是后壁）可用于识别持续性房颤和心脏栓塞性卒中高风险患者。

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Three-dimensional left atrial strain analysis in patients with atrial fibrillation for stroke risk evaluation: A comparison between patients with and without stroke history

Patients with atrial fibrillation (AF) are at risk for cardioembolic stroke. The recent studies suggest that reduced two-dimensional left atrial (LA) deformation, such as longitudinal strain, may be a potential indicator of stroke risk. We aim to evaluate three-dimensional (3-D) LA global and local strain derived from four-dimensional computed tomography angiography in patients with persistent atrial fibrillation, and compare those with and without cardioembolic stroke history.

22 patients with persistent atrial fibrillation (11 with documented cardioembolic stroke) were included in this study. The LA strain was calculated by our novel mesh-regularised sub-volume tracking method. LA morphology, CHADS-VASC2, and 3-D global and local strain in 8 LA regions (anterior, lateral, appendage, roof, posterior, mitral isthmus, floor, and septum) were analysed. To explore the potential performance of the collected parameters for stroke risk evaluation, we used logistic regression to assess the outcomes of using these parameters to identify patients with cardioembolic stroke.

Compared to those without previous stroke events, the patients with cardioembolic stroke presented lower global strain (0.090 vs 0.101; p = 0.006). Patients with cardioembolic stroke also had lower strain values in the roof (0.087 vs 0.106, p = 0.030), posterior (0.055 vs 0.072, p < 0.001) and floor (0.083 vs 0.097, p = 0.022). Results from logistic regression indicated that the accuracy of LA posterior strain as the indicator for previous stroke events was 0.8958.

Therefore, 3-D LA global and local strain (especially in the posterior wall) could be useful in identifying patients with persistent AF and at high risk for a cardioembolic stroke.

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来源期刊

Journal of biomechanics 生物-工程：生物医学

CiteScore

5.10

自引率

4.20%

发文量

345

审稿时长

1 months

期刊介绍： The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership. Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to: -Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells. -Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions. -Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response. -Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing. -Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine. -Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction. -Molecular Biomechanics - Mechanical analyses of biomolecules. -Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints. -Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics. -Sports Biomechanics - Mechanical analyses of sports performance.