【摘要】 目的 分析左心房储存期应变（LASr）与心房颤动（下称房颤）患者射血分数保留的心力衰竭（HFpEF）的关系。方法 前瞻性选择2023年12月至2024年8月宁波市医疗中心李惠利医院心内科住院的症状性房颤患者105例，依据心力衰竭-肺动脉高压-HFpEF评分（HFA-PEFF）分为3组，≤1分（非HFpEF组）22例，2～4分（疑似HFpEF组）56例，≥5分（HFpEF组）27例。所有患者在入院时接受血脑钠肽（BNP）检测和超声心动图检查，并行二维斑点追踪超声心动图检查测量左心室整体长轴应变（LVGLS）、左心房储存期应变（LASr）、右心房储存期应变（RASr）。采用ROC曲线评估左右心房参数对房颤患者发生HFpEF的诊断效能。采用logistic回归分析房颤患者发生HFpEF的独立危险因素。结果 疑似HFpEF和HFpEF组的年龄和BNP高于非HFpEF组；HFpEF组的BNP高于疑似HFpEF组（均P<0.05）。疑似HFpEF和HFpEF组的LASr和RASr低于非HFpEF组，HFpEF组低于疑似HFpEF组（均P<0.05）。多因素logistic回归分析显示女性及LASr是HFpEF独立影响因素，LASr联合女性对房颤患者HFpEF诊断的AUC值为0.830。结论 女性及LASr是房颤患者诊断HFpEF的独立影响因素。更多还原

【Abstract】 Objective To explore the relationship between left atrial reservoir strain(LASr) and heart failure with preserved ejection fraction(HFpEF) in patients with atrial fibrillation(AF). Methods A total of 105 symptomatic AF patients hospitalized in the Department of Cardiology, Ningbo Medical Center Lihuili Hospital from December 2023 to August 2024 were prospectively enrolled and divided into three groups based on the heart failure-pulmonary hypertension-preserved ejection fraction(HFA-PEFF) score: ≤1 point(non HFpEF group)(n=22), 2-4(suspected HFpEF group)(n=56), and ≥5 points(HFpEF group)(n=27). General clinical data were collected. All patients underwent plasma brain natriuretic peptide(BNP) measurement and echocardiography upon admission, and underwent twodimensional speckle tracking echocardiography to measure overall longitudinal strain of the left ventricle, LASr, and right atrial reservoir strain(RASr). ROC curves were used to evaluate the diagnostic efficacy of left and right atrial parameters for HFPEF in patients with AF.Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for HFPEF in patients with AF. Results Age and BNP were higher in the suspected HFpEF and HFpEF than in the non HFpEF group; BNP was higher in the HFpEF group than in the suspected HFpEF group(all P<0.05). LASr and RASr were lower in the suspected HFpEF and HFpEF groups than in the non HFpEF group, and lower in the HFpEF group than in the suspected HFpEF group(all P<0.05). Logistic regression analysis showed that female sex and LASr were independent influencing factors for HFpEF. The combination of LASr and female sex yielded an AUC of 0.830 for diagnosing HFpEF in AF patients. Conclusion Female sex and LASr are independent factors for diognosing HFpEF in patients with AF.更多还原