心房颤动患者左心房纤维化定量诊断指标体系建立OA

Objective To explore the analytical value of late gadolinium-enhanced cardiac magnetic resonance(LGE-CMR)combined with echocardiography parameters and epicardial adipose tissue(EAT)computed tomography(CT)data in assessing left atrial fibrosis severity in patients with atrial fibrillation(AF),and to establish a non-invasive and accurate quantitative diagnostic index system.Methods Patients diagnosed with AF in the Department of Cardiovascular Medicine,the Second Hospital of Lanzhou University from March 2023 to March 2024 were enrolled.LGE-CMR was used to evaluate the severity of left atrial fibrosis,while 2D-STE and CT were performed to obtain ultrasonic parameters and EAT data.Statistical methods such as independent samples t-test and multivariate Logistic regression,combined with receiver operating charac-teristic(ROC)curve,were applied to analyze the associations between AF types,various parameters and left atrial fibrosis,as well as the diagnostic value of these parameters for left atrial fibrosis and their optimal diagnostic cut-off values.Results The independent samples t-test showed that the severity of left atrial fibrosis in patients with persistent AF was significantly higher than that in patients with paroxysmal AF.Multivariate Logistic regression combined with ROC curve analysis revealed that the ultrasonic index peak left atrial strain rate during reservoir phase(pLASRr)had the highest diagnostic value(AUC=0.903,P<0.001),followed by left atrial maximal volume(LAV)(AUC=0.829,P<0.001)and left atrial maximal volume index(LAVI)(AUC=0.815,P<0.001).Conclusion The non-invasive diagnostic system,established with pLASRr,LAV,and LAVI as the main diagnostic indicators,and echocardiographic parameters including left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVDs),left ventricular end-diastolic diameter(LVDd),left atrial stiffness index(LASI),left atrial reservoir strain(LASr),left atrial contraction strain(LASct),left atrial conduit strain(LAScd),peak atrial longitudinal strain(PALS),left atrial appendage diameter(LAA-D),left atrial appendage peak emptying velocity(LAA-PEV),and left atrial epicar-dial adipose tissue volume(LA-EAT)as auxiliary diagnostic indicators,can be used to assess the degree of left atrial fibrosis in patients with atrial fibrillation AF.