Evaluation of left ventricular myocardial work by pressure-strain loop in atrial fibrillation patients with normal left ventricular ejection fraction before and after catheter ablation

doi:10.3877/cma.j.issn.1672-6448.2022.12.002

Abstract

Abstract:

Objective

To quantitatively evaluate the left ventricular myocardial work by pressure-strain loop (PSL) before and after catheter ablation in atrial fibrillation patients with normal left ventricular ejection fraction (LVEF).

Methods

This was a retrospective observational study in which 37 patients with persistent atrial fibrillation receiving catheter ablation from January 2020 to December 2020 at the Second Affiliated Hospital of Anhui Medical University, and 37 healthy subjects were included. All the patients underwent echocardiography before and 3-6 months after ablation. Routine echocardiographic parameters and global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were compared among patients before ablation, those after ablation, and healthy subjects.

Results

There was no significant difference in LVEF among the three groups (P＞0.05). Preoperative GLS, GWI, GCW, and GWE in the atrial fibrillation group were significantly lower than those in the control group, and GWW was significantly higher than that of the control group (P＜0.05 for all). After catheter ablation, GLS, GLS, GWI, GCW, and GWE in the atrial fibrillation group were significantly higher than those before surgery, and GWW was significantly lower than that before surgery (P＜0.05 for all). Compared with the control group, there were no significant differences in GLS, GWI, or GCW in the atrial fibrillation group (P＞0.05), but GWW was significantly higher and GWE was significantly lower than that of control group (P＜0.05 for both).

Conclusion

PSL can quantitatively evaluate the changes of left ventricular myocardial function in atrial fibrillation patients with normal LVEF before and after surgery, and detect myocardial damage in these patients early. Early radiofrequency ablation to restore sinus rhythm can effectively improve the early myocardial damage in these patients.

Key words: Atrial fibrillation, Left ventricular function, Pressure-strain loop, Myocardial work, Catheter ablation

Tingting Wu, Xiang Xie, Fan Jiang, Sihua Fang, Ping Hu, WenChi. Guo. Evaluation of left ventricular myocardial work by pressure-strain loop in atrial fibrillation patients with normal left ventricular ejection fraction before and after catheter ablation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(12): 1323-1328.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.12.002

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I12/1323

Figures/Tables 4

References 17

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组别	例数	年龄（岁）	身高（cm）	体重（kg）	BMI	收缩压（mmHg）	舒张压（mmHg）
对照组	37	58.00±9.93	163.70±7.07	66.19±10.79	24.59±2.99	126.81±13.40	76.00±9.12
心房颤动组	37	60.14±12.23	164.19±7.43	66.51±9.02	24.62±2.63	125.76±13.94	76.43±11.20
t值		-0.825	-0.289	-0.140	-0.054	0.332	-0.182
P值		0.412	0.774	0.889	0.957	0.741	0.856

组别	例数	年龄（岁）	身高（cm）	体重（kg）	BMI	收缩压（mmHg）	舒张压（mmHg）
对照组	37	58.00±9.93	163.70±7.07	66.19±10.79	24.59±2.99	126.81±13.40	76.00±9.12
心房颤动组	37	60.14±12.23	164.19±7.43	66.51±9.02	24.62±2.63	125.76±13.94	76.43±11.20
t值		-0.825	-0.289	-0.140	-0.054	0.332	-0.182
P值		0.412	0.774	0.889	0.957	0.741	0.856

组别	例数	LVDd（mm）	IVS（mm）	LVPW（mm）	LAD（mm）	LVEF（%）
对照组	37	45.51±2.83	9.54±1.84	8.97±1.38	34.97±3.39	60.54±5.44
心房颤动组
术前	37	46.84±4.19	9.22±1.13	8.70±0.94	39.54±6.33^a	58.56±5.03
术后	37	46.79±3.94	9.17±1.11	8.73±0.96	36.86±4.06^ab	61.51±5.57
F值		1.514	0.779	0.661	7.648	2.941
P值		0.225	0.441	0.519	0.001	0.059

组别	例数	LVDd（mm）	IVS（mm）	LVPW（mm）	LAD（mm）	LVEF（%）
对照组	37	45.51±2.83	9.54±1.84	8.97±1.38	34.97±3.39	60.54±5.44
心房颤动组
术前	37	46.84±4.19	9.22±1.13	8.70±0.94	39.54±6.33^a	58.56±5.03
术后	37	46.79±3.94	9.17±1.11	8.73±0.96	36.86±4.06^ab	61.51±5.57
F值		1.514	0.779	0.661	7.648	2.941
P值		0.225	0.441	0.519	0.001	0.059

组别	例数	GLS（-%）	GCW（mmHg%）	GWI（mmHg%）	GWW（mmHg%）	GWE（%）
对照组	37	19.98±1.42	2219.16±329.97	2081.57±308.35	145.81±71.91	92.78±2.98
心房颤动组
术前	37	16.14±3.06^a	1855.43±491.58^a	1638.73±457.94^a	299.81±123.85^a	83.320±6.32^a
术后	37	19.23±1.93^b	2115.86±427.70^b	1950.76±434.89^b	180.86±65.82^ab	89.94±3.79^ab
F值		30.458	7.310	11.634	29.1113	41.366
P值		0.000	0.001	0.000	0.000	0.000

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