Aim. To evaluate volume and strain of the left atrium (LA) in people suffering from paroxysmal atrial fibrillation which is not valvular (NVPAF) using the new technology of left atrial automatic myocardial function imaging (AFILA) and to analyze prognostic factors in patients with NVPAF by follow-up. Methods. Between August 2019 and August 2022, a total of 80 NVPAF patients and 60 normal control patients who were hospitalized in the Department of Cardiology were included in the study. The LA volume and strain parameters of the two groups were analyzed. The differences in LA function (LAF) parameters were compared between the two groups to generate the receiver operating characteristic curve (ROC) and calculate the area under the curve (AUC), sensitivity, and specificity of each parameter. Follow-up was conducted on the 80 NVPAF patients included, their treatment methods after admission and their rehospitalization due to heart events were recorded, and independent risk factors influencing the prognosis of NVPAF were obtained. Results. A total of 140 patients participated in the study, including 80 in the NVPAF group and 60 in the normal control group. There was no statistically significant difference in age and sex between the two groups. Compared to the normal group, the LA minimum volume (LAVmin), LA maximum volume (LAVmax), and volume at onset of LA contraction (LAVpreA) in the NVPAF group were significantly increased. The LA emptying fraction (LAEF) was significantly decreased, and LA reservoir strain (S_R), LA conduit strain (S_CD), and LA contractile strain (S_CT) were significantly compromised ( < 0.05). There was no significant difference in LA evacuation volume (LAEV) reduction ( > 0.05). Logistic regression analysis of LAF parameters in NVPAF patients showed that LAEF and S_R were independently correlated with NVPAF (odds ratio values: 0.883 (0.827–0.943),  < 0.001; 0.916 (0.569–1.474),  = 0.047). The ROC curve results showed that LAEF had a high efficiency in the diagnosis of NVPAF, with  < 0.001, AUC of 0.843, sensitivity of 0.788, and specificity of 0.867. For the LA strain parameters, the S_R test efficiency was higher, with  < 0.001, AUC of 0.762, sensitivity of 0.713, and specificity of 0.783. There was a strong correlation between S_R and LAEF in patients with no end event and those with end event. The ROC curve revealed that the S_R was better than LAEF in predicting prognosis of patients with AF (AUC = 0.914,  < 0.0001 vs. AUC = 0.876,  < 0.0001). S_R of 10.5 and LAEF of 21 were the cut-off values for endpoint events in NVPAF patients, with sensitivity of 0.909 and 0.727 and specificity of 0.904 and 0.901, respectively. Conclusions. AFILA ultrasound technology comprehensively evaluated the LA size and function in patients with NVPAF. The LAEF and S_R were independently correlated with NVPAF and can determine the prognosis of patients with NVPAF.

中文翻译：

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左心房自动心肌功能超声检查评估阵发性心房颤动患者的左心房功能

目的。利用左心房自动心肌功能成像（AFILA）新技术评估非瓣膜性阵发性房颤（NVPAF）患者左心房（LA）的体积和应变，并分析NVPAF患者的预后因素跟进。方法。2019年8月至2022年8月期间，共纳入80例在心内科住院的NVPAF患者和60例正常对照患者。分析两组的LA体积和应变参数。比较两组LA功能（LAF）参数的差异，生成受试者工作特征曲线（ROC），并计算各参数的曲线下面积（AUC）、敏感性和特异性。对80例NVPAF患者进行随访，记录其入院后的治疗方法以及因心脏事件再次住院的情况，获得影响NVPAF预后的独立危险因素。结果。共有140名患者参与了该研究，其中NVPAF组80名，正常对照组60名。两组间年龄、性别无统计学差异。与正常组相比，NVPAF组的LA最小体积（LAVmin）、LAVmax）和LA收缩开始时的体积（LAVpreA）均显着增加。LA 排空分数 (LAEF) 显着降低，LA 储存应变 (S_R)、LA 导管应变 (S_CD) 和 LA 收缩应变 (S_CT) 显着受损 (  < 0.05)。LA 排空量 (LAEV) 减少没有显着差异 (  > 0.05)。NVPAF 患者 LAF 参数的 Logistic 回归分析显示，LAEF 和 S_R 与 NVPAF 独立相关（优势比值：0.883（0.827-0.943）， < 0.001；0.916（0.569-1.474）， = 0.047）。ROC曲线结果显示，LAEF对NVPAF的诊断有较高的效率， <0.001，AUC为0.843，敏感性为0.788，特异性为0.867。对于LA应变参数，S_R检验效率较高， <0.001，AUC为0.762，敏感性为0.713，特异性为0.783。在没有结束事件和有结束事件的患者中，S_R 和 LAEF 之间存在很强的相关性。ROC曲线显示，S_R在预测AF患者预后方面优于LAEF（AUC = 0.914， < 0.0001 vs. AUC = 0.876， < 0.0001）。S_R 10.5 和 LAEF 21 是 NVPAF 患者终点事件的临界值，敏感性分别为 0.909 和 0.727，特异性为 0.904 和 0.901。结论。AFILA超声技术全面评估NVPAF患者的LA大小和功能。LAEF和S_R与NVPAF独立相关，可以判断NVPAF患者的预后。