The value of diastolic function parameters in predicting atrial fibrillation late recurrence after transcatheter radiofre-quency ablation by dual gate Doppler
Objective To evaluate diastolic function parameters by dual gate Doppler of patients with atrial fibrilla-tion(AF)after radiofrequency catheter ablation(RFCA)and to establish a Nomogram model for risk stratification.Methods 133 patients with AF were retrospectively analyzed.According to whether there was late recurrence af-ter RFCA,they were divided into recurrent group and non-recurrent group.All patients underwent echocardiography within 7 days before RFCA.With dual gate Doppler,transmitral flow peak velocity(E)and mitral annular septal or lateral peak velocity e'(S),e'(L)in early diastolic were measured simultaneously in the same cardiac cycle,then E/e'(S),E/e'(L)and the mean value E/e'(M)were automatically calculated.The ratio E/Vp of mitral valve peak E and mitral valve blood diffusion velocity Vp was obtained simultaneously.The consumption time of E/e'and E/Vp measured by dual gate Doppler and traditional method were recorded in 20 randomly selected patients.Receiver oper-ating characteristic curve(ROC)showed the value of diastolic function parameters in predicting AF late recurrence.Univariate and multivariate Logistic regression were used to analyze risk factors of AF late recurrence and Nomogram model was constructed.Results Four patients failed to undergo RFCA,and 6 patients were lost to follow-up.There were 65 cases in the non-recur-rent group and 58 cases in the recurrent group.①Age,proportion of patients with persistent AF and hypertension,left atrial volume index,E/e'(L),E/e'(S),E/e'(M),E/Vp,proportion of patients with tricuspid valve regurgitation velocity＞2.8 m/s increased in patients with recur-rent AF(all P＜0.05).②ROC curve showed that the areas under the curve of E/e'(S),E/e'(L),E/e'(M)and E/Vp in predicting AF late recurrence after RFCA were 0.742,0.678,0.720 and 0.711,respectively.③The acquisition of E/e'and E/Vp by dual gate Doppler took less time than traditional method in three aspects:image acquisition,meas-urement data and total process(P＜0.05).④Logistic regression analysis showed that age,left atrial volume index(LAVI)and E/e'(S)were independent risk factors for AF late recurrence.The Nomogram model constructed based on these three parameters had good predictive value,and the area under the curve for predicting AF 5-year recurrence after RFCA was 0.791.Conclusion E/e'(S)obtained by dual gate Doppler is an independent risk factor for AF late recurrence,and the Nomogram model constructed together with age and LAVI has better predictive value for AF 5-year recurrence.[Chinese Journal of Cardiac Pacing and Electrophysiology,2024,38(2):83-89]
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