2D speckle-tracking echocardiography assessment of left atrial and left ventricular mechanics: outcomes in patients with atrial fibrillation treated with hybrid ablation and left atrial appendage surgical closure.
Andrea Maria Paparella, Luigi Pannone, Gianni Pedrizzetti, Giacomo Talevi, Domenico Giovanni Della Rocca, Antonio Sorgente, Rani Kronenberger, Gaetano Paparella, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Mark La Meir, Andrea Sarkozy, Pedro Brugada, Gian Battista Chierchia, Ali Gharaviri, Carlo De Asmundis
{"title":"2D speckle-tracking echocardiography assessment of left atrial and left ventricular mechanics: outcomes in patients with atrial fibrillation treated with hybrid ablation and left atrial appendage surgical closure.","authors":"Andrea Maria Paparella, Luigi Pannone, Gianni Pedrizzetti, Giacomo Talevi, Domenico Giovanni Della Rocca, Antonio Sorgente, Rani Kronenberger, Gaetano Paparella, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Mark La Meir, Andrea Sarkozy, Pedro Brugada, Gian Battista Chierchia, Ali Gharaviri, Carlo De Asmundis","doi":"10.3389/fbioe.2025.1538809","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Hybrid atrial fibrillation (AF) ablation is a therapeutic option in non-paroxysmal AF. Our study examines cardiac mechanics changes after hybrid AF ablation plus epicardial closure of left atrial appendage (LAA).</p><p><strong>Methods: </strong>All consecutive patients undergoing hybrid AF ablation at UZ Brussel were evaluated. They received pulmonary vein isolation (PVI), posterior wall isolation (LAPWI), and epicardial LAA closure. Left atrium (LA) and Left ventricle (LV) mechanics were analyzed, with the following measures obtained at baseline, post-ablation, and follow-up: 1) volumes (EDV, ESV); 2) ejection fraction (EF); 3) strain (ENDO GCS, ENDO GLS); 4) forces (LVLF, LVsysLF, LVim, LVs).</p><p><strong>Results: </strong>A total of 50 patients were included. At follow-up, LAEDV decreased from baseline [44.7 mL vs 53.8 mL, <i>P</i> = 0.025]. LA ENDO GCS and GLS increased post-ablation, with further GLS improvement at follow-up. LV ENDO GCS and LV ENDO GLS also rose post-ablation [-26.7% vs. -22.5%, <i>P</i> < 0.001] and [-20.57% vs. -16.6%, <i>P</i> < 0.001], respectively. LVEF increased post-ablation [54.6% vs 46.3%, <i>P</i> < 0.001]. There was an increase in all LV hemodynamic forces (HDFs) and in particular: LVLF and LVsysLF increased post-ablation [15.5% vs 10.4%, <i>P</i> < 0.001] and [21.5% vs 14.11%, <i>P</i> < 0.001], respectively. LVim also increased post-ablation [19.6% vs 12.8%, <i>P</i> < 0.001]. Finally, there was an increase in LVs post-ablation compared to baseline [10.6% vs 5.4%, <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>In patients undergoing hybrid AF ablation, there was a significant and persistent improvement in the mechanical and hemodynamic functions of both LA and LV.</p>","PeriodicalId":12444,"journal":{"name":"Frontiers in Bioengineering and Biotechnology","volume":"13 ","pages":"1538809"},"PeriodicalIF":4.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937039/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Bioengineering and Biotechnology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3389/fbioe.2025.1538809","RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aims: Hybrid atrial fibrillation (AF) ablation is a therapeutic option in non-paroxysmal AF. Our study examines cardiac mechanics changes after hybrid AF ablation plus epicardial closure of left atrial appendage (LAA).
Methods: All consecutive patients undergoing hybrid AF ablation at UZ Brussel were evaluated. They received pulmonary vein isolation (PVI), posterior wall isolation (LAPWI), and epicardial LAA closure. Left atrium (LA) and Left ventricle (LV) mechanics were analyzed, with the following measures obtained at baseline, post-ablation, and follow-up: 1) volumes (EDV, ESV); 2) ejection fraction (EF); 3) strain (ENDO GCS, ENDO GLS); 4) forces (LVLF, LVsysLF, LVim, LVs).
Results: A total of 50 patients were included. At follow-up, LAEDV decreased from baseline [44.7 mL vs 53.8 mL, P = 0.025]. LA ENDO GCS and GLS increased post-ablation, with further GLS improvement at follow-up. LV ENDO GCS and LV ENDO GLS also rose post-ablation [-26.7% vs. -22.5%, P < 0.001] and [-20.57% vs. -16.6%, P < 0.001], respectively. LVEF increased post-ablation [54.6% vs 46.3%, P < 0.001]. There was an increase in all LV hemodynamic forces (HDFs) and in particular: LVLF and LVsysLF increased post-ablation [15.5% vs 10.4%, P < 0.001] and [21.5% vs 14.11%, P < 0.001], respectively. LVim also increased post-ablation [19.6% vs 12.8%, P < 0.001]. Finally, there was an increase in LVs post-ablation compared to baseline [10.6% vs 5.4%, P < 0.001].
Conclusion: In patients undergoing hybrid AF ablation, there was a significant and persistent improvement in the mechanical and hemodynamic functions of both LA and LV.
背景和目的：混合心房颤动（AF）消融是治疗非阵发性房颤的一种选择。我们的研究考察了混合心房颤动消融加左心房附件（LAA）心外膜闭合后心脏力学的变化。方法：对所有连续在布鲁塞尔UZ接受混合房颤消融的患者进行评估。他们接受肺静脉隔离（PVI）、后壁隔离（LAPWI）和心外膜LAA关闭。左心房（LA）和左心室（LV）力学分析，在基线、消融后和随访时获得以下指标：1)容积（EDV、ESV）；2)射血分数（EF）；3)应变（ENDO GCS, ENDO GLS）；4)力（LVLF, LVsysLF, LVim, LVs）。结果：共纳入50例患者。随访时，LAEDV较基线下降[44.7 mL vs 53.8 mL, P = 0.025]。消融后LA ENDO GCS和GLS增加，随访时GLS进一步改善。消融后左室ENDO GCS和左室ENDO GLS也分别升高[-26.7%对-22.5%,P < 0.001]和[-20.57%对-16.6%,P < 0.001]。消融后LVEF升高[54.6% vs 46.3% P < 0.001]。所有左室血流动力学力（HDFs）均增加，尤其是消融后lvlv和LVsysLF分别增加[15.5% vs 10.4%, P < 0.001]和[21.5% vs 14.11%, P < 0.001]。消融后LVim也升高[19.6% vs 12.8%, P < 0.001]。最后，与基线相比，消融后的LVs增加了[10.6%对5.4%,P < 0.001]。结论：在接受混合房颤消融的患者中，左室和左室的机械和血流动力学功能都有显著和持续的改善。
期刊介绍：
The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs.
In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
