Four-dimensional automatic left atrial quantification technology for evaluating left atrial structure and function in patients with heart failure with preserved ejection fraction complicated by paroxysmal atrial fibrillation

doi:10.3877/cma.j.issn.1672-6448.2025.12.001

Abstract

Abstract:

Objective

To evaluate left atrial structure and function in patients with heart failure with preserved ejection fraction (HFpEF) complicated by paroxysmal atrial fibrillation (AF) using four-dimensional automated left atrial quantification (4D Auto LAQ) technology, and to explore the correlation between LA remodeling and AF in HFpEF patients.

Methods

A total of 109 HFpEF patients admitted to the First Affiliated Hospital of Zhengzhou University from December 2023 to December 2024 were enrolled and divided into a paroxysmal AF group (n=40) and a non-AF group (n=69). Clinical data were collected, and echocardiographic parameters (2D, color Doppler, and tissue Doppler) were measured. 4D Auto LAQ was applied to obtain LA volumetric and strain parameters [left atrial minimum volume (LAV_min), left atrial maximum volume index (LAVI_max), left atrial pre-systolic volume (LAV_preA), left atrial stroke volume (LAEV), left atrial total ejection fraction (LAEF), left atrial systolic longitudinal and circumferential strain (LASr/LASr-c), left atrial pipeline longitudinal and circumferential strain (LAScd/LAScd-c), and left atrial systolic longitudinal and circumferential strain (LASct/LASct-c)]. Differences in these parameters between the two groups were assessed using the t-test. Receiver operating characteristic (ROC) curve analysis was performed to assess the overall diagnostic efficacy of left atrial parameters for HFpEF combined with paroxysmal AF and calculate the optimal cut-off value. Logistic regression analysis was utilized to analyze the correlation between left atrial parameters and the occurrence of paroxysmal AF in patients with HFpEF.

Results

Compared to the non-AF group, the paroxysmal AF group showed increased LAV_min, LAVI_max, and LAV_preA [(64.08±16.44) ml vs (36.67±15.68) ml; (51.68±11.56) ml/m²vs (38.13±10.38) ml/m²; (71.93±16.80) ml vs (50.17±16.99) ml], and the differences were statistically significant (t=-6.610, -6.297, and -5.660, respectively, all P＜0.001). The absolute values of LAEV, LAEF, LASr, LASr-c, LAScd, LAScd-c, LASct, and LASct-c were all decreased [(20.93±6.44) ml vs (27.26±9.28) ml; (25.23±7.88)% vs (43.55±9.70)%; (6.78±3.42)% vs (14.41±4.15)%; (7.60±4.25)% vs (21.25±9.59)%; (-4.93±3.08)% vs (-8.65±3.46)%; (-4.93±3.38)% vs (-10.14±5.60)%; (-1.90±3.39) vs (-5.81±3.26); (-2.83±3.24)% vs (-11.72±5.89)%; all P＜0.001). LASr demonstrated the highest diagnostic performance for identifying HFpEF with paroxysmal AF (area under the curve [AUC]=0.928, 95% confidence interval [CI]: 0.875-0.980, P＜0.001), with an optimal cutoff value of 8.5%, sensitivity of 72.5%, and specificity of 97.1%. Logistic regression analysis demonstrated that LASr was independently associated with paroxysmal AF in HFpEF patients after adjusting for clinical and other echocardiographic parameters (odds ratio=0.340, 95%CI: 0.137-0.847, P=0.011).

Conclusion

The LASr measured by 4D Auto LAQ technology is independently associated with the presence of paroxysmal AF in patients with HFpEF.

Key words: Four-dimensional automatic quantitative technology, Heart failure with preserved ejection fraction, Atrial fibrillation, Left atrial

Xin Hu, Danke Ma, Manman Yang, Shoujing Wang, Cunying Cui, Lin Liu, Chengzeng Wang. Four-dimensional automatic left atrial quantification technology for evaluating left atrial structure and function in patients with heart failure with preserved ejection fraction complicated by paroxysmal atrial fibrillation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(12): 1097-1105.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2025.12.001

https://chaosheng.cma-cmc.com.cn/EN/Y2025/V22/I12/1097

Figures/Tables 6

项目	无房颤组（69例）	阵发性房颤组（40例）	统计值	P值
年龄（岁， $x ¯$ ±s）	62.99±11.40	71.75±7.84	t=-4.740	＜0.001
男性/女性（例）	33/36	16/24	χ²=0.627	0.429
体质量指数[kg/m²，M（Q₁，Q₃）]	1.72（1.60，1.87）	1.66（1.55，1.86）	Z=-1.267	0.205
心率（次/min， $x ¯$ ±s）	72.29±11.708	76.53±11.856	t=-1.799	0.076
收缩压（mmHg， $x ¯$ ±s）	138.19±22.660	132.83±18.685	t=1.267	0.208
舒张压（mmHg， $x ¯$ ±s）	77.61±14.974	78.93±11.720	t=-0.477	0.634
NYHA III/IV级[例（%）]	35（50.7）	32（80.0）	χ²=9.163	0.002
NT-proBNP[pg/ml，M（Q₁，Q₃）]	660.00（304.50，932.00）	1234.00（788.50，2948.25）	Z=-4.212	＜0.001
肌酐[mg/ml，M（Q₁，Q₃）]	85.00（67.00，199.50）	81.50（65.25，92.50）	Z=-1.959	0.055
eGFR[ml/min，M（Q₁，Q₃）]	63.00（21.14，91.36）	75.12（61.08，89.75）	Z=-1.641	0.101
房颤病程[年，M（Q₁，Q₃）]	-	2.88（1.67，4.09）	-	-
高血压[例（%）]	47（68.1）	28（70.0）	χ²=0.042	0.838
糖尿病[例（%）]	22（31.9）	4（10.0）	χ²=6.676	＜0.001
慢性肾病[例（%）]	20（29.0）	3（7.5）	χ²=7.021	0.008
卒中病史[例（%）]	15（21.7）	7（17.5）	χ²=0.081	0.776
高脂血症[例（%）]	10（15.4）	4（10.0）	χ²=0.243	0.622
β受体阻滞剂[例（%）]	45（65.2）	25（62.5）	χ²=0.081	＜0.001
钙离子通道阻滞剂[例（%）]	33（47.8）	15（37.5）	χ²=1.096	0.295
血管紧张素酶抑制剂/血管紧张素受体拮抗剂[例（%）]	48（69.6）	27（67.5）	χ²=0.050	0.823
他汀类药物[例（%）]	61（88.4）	33（82.5）	χ²=0.744	0.388
抗凝药[例（%）]	14（20.3）	39（97.5）	χ²=60.426	＜0.001
抗血小板聚集抑制剂[例（%）]	50（72.5）	21（52.5）	χ²=4.444	0.035
袢利尿剂[例（%）]	41（59.4）	32（80.0）	χ²=4.848	0.028
噻嗪类利尿剂[例（%）]	5（7.2）	2（5.0）	χ²=0.003	0.956
醛固酮受体拮抗剂[例（%）]	28（41.8）	25（62.5）	χ²=4.297	0.038

项目	无房颤组（69例）	阵发性房颤组（40例）	统计值	P值
年龄（岁， $x ¯$ ±s）	62.99±11.40	71.75±7.84	t=-4.740	＜0.001
男性/女性（例）	33/36	16/24	χ²=0.627	0.429
体质量指数[kg/m²，M（Q₁，Q₃）]	1.72（1.60，1.87）	1.66（1.55，1.86）	Z=-1.267	0.205
心率（次/min， $x ¯$ ±s）	72.29±11.708	76.53±11.856	t=-1.799	0.076
收缩压（mmHg， $x ¯$ ±s）	138.19±22.660	132.83±18.685	t=1.267	0.208
舒张压（mmHg， $x ¯$ ±s）	77.61±14.974	78.93±11.720	t=-0.477	0.634
NYHA III/IV级[例（%）]	35（50.7）	32（80.0）	χ²=9.163	0.002
NT-proBNP[pg/ml，M（Q₁，Q₃）]	660.00（304.50，932.00）	1234.00（788.50，2948.25）	Z=-4.212	＜0.001
肌酐[mg/ml，M（Q₁，Q₃）]	85.00（67.00，199.50）	81.50（65.25，92.50）	Z=-1.959	0.055
eGFR[ml/min，M（Q₁，Q₃）]	63.00（21.14，91.36）	75.12（61.08，89.75）	Z=-1.641	0.101
房颤病程[年，M（Q₁，Q₃）]	-	2.88（1.67，4.09）	-	-
高血压[例（%）]	47（68.1）	28（70.0）	χ²=0.042	0.838
糖尿病[例（%）]	22（31.9）	4（10.0）	χ²=6.676	＜0.001
慢性肾病[例（%）]	20（29.0）	3（7.5）	χ²=7.021	0.008
卒中病史[例（%）]	15（21.7）	7（17.5）	χ²=0.081	0.776
高脂血症[例（%）]	10（15.4）	4（10.0）	χ²=0.243	0.622
β受体阻滞剂[例（%）]	45（65.2）	25（62.5）	χ²=0.081	＜0.001
钙离子通道阻滞剂[例（%）]	33（47.8）	15（37.5）	χ²=1.096	0.295
血管紧张素酶抑制剂/血管紧张素受体拮抗剂[例（%）]	48（69.6）	27（67.5）	χ²=0.050	0.823
他汀类药物[例（%）]	61（88.4）	33（82.5）	χ²=0.744	0.388
抗凝药[例（%）]	14（20.3）	39（97.5）	χ²=60.426	＜0.001
抗血小板聚集抑制剂[例（%）]	50（72.5）	21（52.5）	χ²=4.444	0.035
袢利尿剂[例（%）]	41（59.4）	32（80.0）	χ²=4.848	0.028
噻嗪类利尿剂[例（%）]	5（7.2）	2（5.0）	χ²=0.003	0.956
醛固酮受体拮抗剂[例（%）]	28（41.8）	25（62.5）	χ²=4.297	0.038

参数	无房颤组（69例）	阵发性房颤组（40例）	统计值	P值
LVEDD（mm， $x ¯$ ±s）	50.00±6.36	47.37±7.48	t=-1.996	0.046
LVEF（%， $x ¯$ ±s）	57.94±5.59	55.80±5.33	t=10.161	＜0.001
LVESV[ml，M（Q₁，Q₃）]	37.00（27.50，56.50）	41.50（26.25，52.00）	Z=-0.365	0.715
LVEDV[ml，M（Q₁，Q₃）]	95.00（68.50，130.00）	88.50（56.50，1112.25）	Z=-1.141	0.254
RWT（ $x ¯$ ±s）	0.45±0.09	0.44±0.21	t=-1.563	0.118
LVMI（g/m²， $x ¯$ ±s）	126.26±31.18	103.39±30.39	t=3.726	＜0.001
E（cm/s， $x ¯$ ±s）	0.72±0.17	0.88±0.30	t=-2.732	0.006
A（cm/s， $x ¯$ ±s）	0.85±0.34	0.74±0.18	t=-1.348	0.178
E/A[M（Q₁，Q₃）]	0.80（0.61，1.20）	2.02（1.90，2.13）	Z=-11.795	＜0.001
间隔侧e' [M（Q₁，Q₃）]	0.06（0.05，0.07）	0.05（0.05，0.06）	Z=-3.212	0.001
侧壁侧e' [M（Q₁，Q₃）]	0.07（0.06，0.08）	0.09（0.07，0.10）	Z=-2.770	0.006
E/e' [M（Q₁，Q₃）]	12.74（11.72，13.76）	14.40（13.01，15.77）	Z=-2.006	0.047
TR（m/s， $x ¯$ ±s）	2.56±0.45	2.60±0.43	t=0.209	0.290
PASP（mmHg， $x ¯$ ±s）	32.49±11.72	37.28±11.44	t=-2.075	0.040
TAPSE（mm， $x ¯$ ±s）	20.30±4.02	17.56±3.80	t=-3.601	＜0.001
LV-GLS（%， $x ¯$ ±s）	-15.56±5.33	-13.36±3.35	t=-3.452	＜0.001

参数	无房颤组（69例）	阵发性房颤组（40例）	统计值	P值
LVEDD（mm， $x ¯$ ±s）	50.00±6.36	47.37±7.48	t=-1.996	0.046
LVEF（%， $x ¯$ ±s）	57.94±5.59	55.80±5.33	t=10.161	＜0.001
LVESV[ml，M（Q₁，Q₃）]	37.00（27.50，56.50）	41.50（26.25，52.00）	Z=-0.365	0.715
LVEDV[ml，M（Q₁，Q₃）]	95.00（68.50，130.00）	88.50（56.50，1112.25）	Z=-1.141	0.254
RWT（ $x ¯$ ±s）	0.45±0.09	0.44±0.21	t=-1.563	0.118
LVMI（g/m²， $x ¯$ ±s）	126.26±31.18	103.39±30.39	t=3.726	＜0.001
E（cm/s， $x ¯$ ±s）	0.72±0.17	0.88±0.30	t=-2.732	0.006
A（cm/s， $x ¯$ ±s）	0.85±0.34	0.74±0.18	t=-1.348	0.178
E/A[M（Q₁，Q₃）]	0.80（0.61，1.20）	2.02（1.90，2.13）	Z=-11.795	＜0.001
间隔侧e' [M（Q₁，Q₃）]	0.06（0.05，0.07）	0.05（0.05，0.06）	Z=-3.212	0.001
侧壁侧e' [M（Q₁，Q₃）]	0.07（0.06，0.08）	0.09（0.07，0.10）	Z=-2.770	0.006
E/e' [M（Q₁，Q₃）]	12.74（11.72，13.76）	14.40（13.01，15.77）	Z=-2.006	0.047
TR（m/s， $x ¯$ ±s）	2.56±0.45	2.60±0.43	t=0.209	0.290
PASP（mmHg， $x ¯$ ±s）	32.49±11.72	37.28±11.44	t=-2.075	0.040
TAPSE（mm， $x ¯$ ±s）	20.30±4.02	17.56±3.80	t=-3.601	＜0.001
LV-GLS（%， $x ¯$ ±s）	-15.56±5.33	-13.36±3.35	t=-3.452	＜0.001

参数	无房颤组（69例）	阵发性房颤组（40例）	t值	P值
LAV_min（ml）	36.67±15.68	64.08±16.44	-6.610	＜0.001
LAV_preA（ml）	50.17±16.99	71.93±16.80	-5.660	＜0.001
LAVI_max（ml/m²）	38.13±10.38	51.68±11.56	-6.297	＜0.001
LAEV（ml）	27.26±9.28	20.93±6.44	3.813	＜0.001
LAEF（%）	43.55±9.70	25.23±7.88	10.161	＜0.001
LASr（%）	14.41±4.15	6.78±3.42	9.839	＜0.001
LAScd（%）	-8.65±3.46	-4.93±3.08	-5.632	＜0.001
LASct（%）	-5.81±3.26	-1.90±3.39	-5.947	＜0.001
LASr-c（%）	21.25±9.59	7.60±4.25	-7.413	＜0.001
LAScd-c（%）	-10.14±5.60	-4.93±3.38	-5.352	＜0.001
LASct-c（%）	-11.72±5.89	-2.83±3.24	-8.831	＜0.001

参数	曲线下面积	95%CI	截断值（%）	敏感度（%）	特异度（%）	P值
LAV_min	0.879	0.810~0.949	46.00	90.0	77.9	＜0.001
LAVI_max	0.813	0.731~0.895	39.50	87.5	60.3	＜0.001
LAV_preA	0.824	0.743~0.905	62.50	75.0	80.9	＜0.001
LAEF	0.710	0.611~0.809	29.50	80.0	89.9	＜0.001
LAEV	0.922	0.869~0.975	21.50	65.0	72.5	＜0.001
LASr	0.928	0.875~0.980	-8.50	72.5	97.1	＜0.001
LAScd	0.789	0.704~0.874	-5.50	65.0	80.9	＜0.001
LASct	0.792	0.705~0.879	-2.50	60.0	82.4	＜0.001
LASr-c	0.927	0.875~0.978	10.50	87.5	88.4	＜0.001
LAScd-c	0.783	0.698~0.869	-7.50	82.5	66.2	＜0.001
LASct-c	0.908	0.855~0.962	-5.50	85.0	83.8	＜0.001

参数	观察者内		观察者间
参数	ICC	95%CI	ICC	95%CI
LAV_min	0.988	0.893~0.999	0.986	0.883~0.999
LAV_max	0.996	0.969~0.999	0.992	0.939~0.999
LAV_preA	0.978	0.935~0.992	0.989	0.967~0.998
LAVI_max	0.995	0.928~1.000	0.998	0.963~1.000
LAEV	0.994	0.944~0.999	0.997	0.96671~1.000
LAEF	0.984	0.853~0.998	0.992	0.920~0.999
LASr	0.973	0.861~0.997	0.982	0.948~0.994
LAScd	0.946	0.847~0.981	0.905	0.741~0.967
LASct	0.969	0.787~0.997	0.937	0.743~0.993
LASr-c	0.988	0.939~0.999	0.989	0.902~0.999
LAScd-c	0895	0.611~0.987	0.962	0.825~0.996
LASct-c	0.957	0.714~0.995	0.967	0.721~0.997

References 24

1	Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction [J]. J Am Coll Cardiol, 2023, 81(18): 1835-1878.
2	Patel RB, Greene SJ, Xu H, et al. Intersection of atrial fibrillation and heart failure with mildly reduced and preserved ejection fraction in ＞400 000 participants in the get with the guidelines‐heart failure registry [J]. Eur J Heart Fail, 2023, 25(1): 63-73.
3	Weerts J, Barandiarán Aizpurua A, Henkens MTHM, et al. The prognostic impact of mechanical atrial dysfunction and atrial fibrillation in heart failure with preserved ejection fraction [J]. Eur Heart J Cardiovasc Imaging, 2021, 23(1): 74-84.
4	Heijman J, Linz D, Schotten U. Dynamics of atrial fibrillation mechanisms and comorbidities [J]. Annu Rev Physiol, 2021, 83(1): 83-106.
5	Chen L, Zhang C, Wang J, et al. Left atrial strain measured by 4D Auto LAQ echocardiography is significantly correlated with high risk of thromboembolism in patients with non-valvular atrial fibrillation [J]. Quant Imaging Med Surg, 2021, 11(9): 3920-3931.
6	Nagueh SF, Sanborn DY, Oh JK, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography and for heart failure with preserved ejection fraction diagnosis: an update from the american society of echocardiography [J]. J Am Soc Echocardiogr, 2025, 38(7): 537-569.
7	Pieske B, Tschöpe C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) [J]. Eur J Heart Fail, 2020, 22(3): 391-412.
8	中华医学会心血管病学分会, 中国生物医学工程学会心律分会. 心房颤动诊断和治疗中国指南 [J]. 中华心血管病杂志, 2023, 51(6): 572-618.
9	Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J]. Eur Heart J Cardiovasc Imaging, 2015, 16(3): 233-271.
10	赵志玉, 陈金玲, 周青, 等. 心肌纵向分层应变参数评价冠心病患者左心室局部及整体收缩功能 [J]. 中华超声影像学杂志, 2016, 25(1): 1-6.
11	Son MK, Park JJ, Lim NK, et al. Impact of atrial fibrillation in patients with heart failure and reduced, mid-range or preserved ejection fraction [J]. Heart, 2020, 106(15): 1160-1168.
12	Carlisle MA, Fudim M, DeVore AD, et al. Heart failure and atrial fibrillation, like fire and fury [J]. JACC Heart Fail, 2019, 7(6): 447-456.
13	Park JJ, Park JH, Hwang IC, et al. Left atrial strain as a predictor of new-onset atrial fibrillation in patients with heart failure [J]. JACC Cardiovasc Imaging, 2020, 13(10): 2071-2081.
14	阿布力皮孜阿布都卡迪尔, 谭玉婷, 候全飞, 等. 斑点追踪超声心动图在评估左心室舒张功能障碍中的应用进展 [J/OL]. 中华医学超声杂志(电子版), 2023, 20(12): 1304-1307.
15	Kuppahally SS, Akoum N, Burgon NS, et al. Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI [J]. Circ Cardiovasc Imaging, 2010, 3(3): 231-239.
16	Patel RB, Shah SJ. Therapeutic targeting of left atrial myopathy in atrial fibrillation and heart failure with preserved ejection fraction [J]. JAMA Cardiol, 2020, 5(5): 497.
17	Zakeri R, Borlaug BA, McNulty SE, et al. Impact of atrial fibrillation on exercise capacity in heart failure with preserved ejection fraction: a RELAX trial ancillary study [J]. Circ Heart Fail, 2014, 7(1): 123-130.
18	Reddy YNV, Obokata M, Verbrugge FH, et al. Atrial dysfunction in patients with heart failure with preserved ejection fraction and atrial fibrillation [J]. J Am Coll Cardiol, 2020, 76(9): 1051-1064.
19	Ito T, Noda T, Nochioka K, et al. Clinical impact of atrial fibrillation progression in patients with heart failure with preserved ejection fraction: a report from the CHART-2 study [J]. Europace, 2024, 26(9): euae218.
20	Rillig A, Magnussen C, Ozga AK, et al. Early rhythm control therapy in patients with atrial fibrillation and heart failure [J]. Circulation, 2021, 144(11): 845-858.
21	时伟强, 陆静, 李娜娜, 等. 左房应变参数联合左心耳排空速度预测持续性心房颤动消融术后早期复发的临床价值 [J]. 临床超声医学杂志, 2025, 27(3): 204-209.
22	Benjamin MM, Moulki N, Waqar A, et al. Association of left atrial strain by cardiovascular magnetic resonance with recurrence of atrial fibrillation following catheter ablation [J]. J Cardiovasc Magn Reson, 2022, 24(1): 3.
23	Giubertoni A, Boggio E, Ubertini E, et al. Atrial conduit function quantitation precardioversion predicts early arrhythmia recurrence in persistent atrial fibrillation patients [J]. J Cardiovasc Med (Hagerstown), 2019, 20(4): 169-179.
24	Thomas L, Marwick TH, Popescu BA, et al. Left atrial structure and function, and left ventricular diastolic dysfunction [J]. J Am Coll Cardiol, 2019, 73(15): 1961-1977.

[1]	Bo Xu, Hanlin Guo, Changhui Lei, Jing Li, Yiding Zhou, Shengjun Tuo, Weixun Duan, Rong Zhao, Jincheng Liu, Liwen Liu. Correlation between left atrial/left ventricular diameter ratio and degree of left ventricular outflow tract obstruction in patients with obstructive hypertrophic cardiomyopathy [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(04): 354-359.
[2]	Yuxin Cao, Zhuojun Mao, Jiahe Liang, Jiangpu Yi, Zekai Zhang, Wenshuai Ma, Yuntao Chen, Xiaoqian Li, Yuxin Zhang, Tiesheng Cao, Lijun Yuan. Application of three-dimensional printed heart model in simulating clinical teaching of left atrial appendage closure [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(06): 602-607.
[3]	Jinghan Xia, Fengjiao Lin, Yi Wang, Geqi Ding, Qingfeng Zhang, Hongmei Zhang, Shenghua Xie, Mingxing Li, Lixue Yin, Wenhua Li. Predictive value of mitral valve spatial changes combined with left atrial strain for left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(06): 585-592.
[4]	Shuiqing Wang, Bowen Zhao, Mei Pan, Xiaohui Peng, Ran Chen, Mingming Ma, Min Di. Quantitative assessment of posterior left atrial space index (PLASI) and PLASI Z-score in normal fetuses at 16-40 weeks of gestation [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(05): 460-469.
[5]	Xiaoli Wang, Xiaoyuan Wang, Hongtao Sun. Influencing factors for prognoses of elderly patients with acute ischemic stroke and atrial fibrillation [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2025, 11(02): 111-116.
[6]	Tao Zhou, Zihe Cheng, Hongfang Zheng, Jiaqi Liu, Xueqin Xu, Shengyu Wang. Current anticoagulation treatment strategies for sepsis with new-onset atrial fibrillation [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2025, 11(04): 402-406.
[7]	Guoliang Cao, Huihua Shi, Zhu Zhu, Cen Du. Correlation of nocturnal pulse pressure and nocturnal pulse pressure index with cardiac function and prognosis in elderly patients with mild-to-moderate hypertension complicated with heart failure with preserved ejection fraction [J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(10): 733-740.
[8]	Xinru Chai, Yaxi Wang, Minjie Zhang, Yilu Shi, Shasha Duan, Xuhui Li, Xiaoshan Zhang. Progress in research of atrial fibrillation in unexplained embolic stroke [J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(01): 68-74.
[9]	Haocheng Wang, Jikai Wang, Zirui Liu, Yunjuan Sun, Jing Zhou, Yang Liu, Mingqiang Cao, Cao Zou. Feasibility evaluation of zero-fluoroscopy radiofrequency catheter ablation for atrial fibrillation guided by 3D mapping system and intracardiac echocardiography [J]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2025, 13(04): 214-220.
[10]	Jianhua Wang, Weili Fan, Haihan Guo, Lu Sun, Meng Zhang, Jian Xu, Shufeng Li, Wei Cao. Research on the correlation factors of thrombus formation in non-valvular atrial fibrillation patients after standard anticoagulation [J]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2025, 13(01): 38-46.
[11]	Shuai Shang, Yaodong Li, Yanmei Lu, Qiang Xing, Jianghua Zhang, Xianhui Zhou, Baopeng Tang. Experience of single-center with different anticoagulation strategies after one-stop operation in patients with non-valvular atrial fibrillation [J]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2024, 12(04): 206-211.
[12]	Yao Xiao, Yuying Bai, Wendan Tao, Bo Wu. Impact of atrial fibrillation treatment on cognitive function: an umbrella review of systematic reviews [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(03): 234-243.
[13]	Zhiyong Fu, Xin Ma, Jing Dong, Xiangying Du, Chunlin Yin. Impact of total atherosclerosis burden in baroreceptor-resident arteries on newly detected atrial fibrillation after stroke [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(03): 175-183.
[14]	Fang Li, Tinghao Guo, Zhijuan Cheng, Jianglong Tu. Research advances in atrial fibrillation detected after stroke [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(01): 68-73.
[15]	Yi Zheng, Ying Liu, Yukun Zhang, Guangping Li, Kangyin Chen, Tong Liu. The effects of preexisting and new-onset atrial fibrillation on the long-term risk of stroke in patients with acute myocardial infarction [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(05): 406-417.

Please choose a citation manager

Content to export