转化医学杂志2026，Vol.15Issue(6)：945-950,6.DOI:10.3639/j.issn.2095-3097.2026.06.009
二维斑点追踪技术对心房颤动合并功能性二尖瓣反流患者导管消融疗效的评估价值
The Evaluation of Catheter Ablation Efficacy in Atrial Fibrillation with Functional Mitral Regurgitation by Two-Dimensional Speckle Tracking Imaging
摘要
Abstract
Objective To explore the evaluation value of two-dimensional speckle tracking imaging(2D-STI)in the efficacy of catheter ablation for patients with atrial fibrillation complicated with atrial functional mitral regurgitation(AFMR).Methods A total of 80 patients diagnosed with atrial fibrillation complicated with AFMR and undergoing catheter ablation at Changsha First Hospital between January 2023 and January 2025 were retrospectively enrolled.According to the results of echocardiography at 6 months after operation,the patients were divided into an improvement group(41 cases)and a non-improvement group(39 cases).The 2D-STI parameters[including left atrial reservoir strain(LASr),left atrial conduit strain(LAScd),and left atrial contractile strain(LASct)]were compared between the two groups at 6 months after surgery.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of 2D-STI parameters for the efficacy of catheter ablation in patients with atrial fibrillation complicated with AFMR.Multivariate stepwise logistic regression analysis was used to identify the influencing factors of catheter ablation efficacy in these patients.Results The LASr in the improvement group was significantly higher than that in the non-improvement group,while the LAScd and LASct were significantly lower(P<0.001).ROC curve analysis showed that the areas under the curve(AUC)of LASr,LAScd,and LASct for predicting the efficacy of catheter ablation in patients with atrial fibrillation complicated with AFMR were 0.719,0.738,and 0.702,respectively.The AUC of the combined prediction of the three parameters was 0.907,which was superior to any single parameter(P<0.001).The LAD,CHA2DS2-VASc score,severity of mitral regurgitation(severe),persistent atrial fibrillation,failure to maintain sinus rhythm at 6 months postoperatively,atrial fibrillation detected during echocardiography at 6 months postoperatively,and postoperative atrial fibrillation burden were higher in the non-improvement group than in the improvement group(P<0.05).Multivariate Logistic stepwise regression analysis showed that persistent atrial fibrillation,failure to maintain sinus rhythm at 6 months postoperatively,high LAD,high CHA2DS2-VASc score,and low LASr were independent risk factors for catheter ablation efficacy in patients with atrial fibrillation complicated with AFMR(OR=2.085,95%CI:1.136-3.829,P=0.018;OR=2.210,95%CI:1.262-3.871,P=0.006;OR=2.230,95%CI:1.281-3.883,P=0.005;OR=2.328,95%CI:1.345-4.030,P=0.003;OR=2.532,95%CI:1.533-4.182,P<0.001).Conclusion The left atrial strain parameters measured by 2D-STI,especially LASr,can effectively evaluate the efficacy of catheter ablation in patients with atrial fibrillation and AFMR,and can be combined with clinical indicators to identify high-risk patients with poor prognosis.关键词
心房颤动/心房功能性二尖瓣反流/导管消融/二维斑点追踪技术/预后Key words
atrial fibrillation/atrial functional mitral regurgitation/catheter ablation/two-dimensional speckle tracking imaging/prognosis引用本文复制引用
王巧凤,王照飞,唐奇,雷国龙,彭超..二维斑点追踪技术对心房颤动合并功能性二尖瓣反流患者导管消融疗效的评估价值[J].转化医学杂志,2026,15(6):945-950,6.基金项目
湖南省卫生健康委科研计划项目(D202303016838) （D202303016838）
长沙市科技计划项目(kq2403198) （kq2403198）
