| Background:Mitral valve insufficiency is a common cause of heart failure,often accompanied by sudden death,infective endocarditis,and arrhythmia,and is a major source of cardiovascular morbidity and mortality.Secondary changes and deformations caused by mitral structural defects and ventricular size abnormalities are associated with the development of these valve lesions.Abnormal valve leaflet structure caused by valve insufficiency is called primary mitral regurgitation,and secondary mitral regurgitation is secondary to the left ventricle.Remodeling and enlargement lead to mitral insufficiency.Echocardiography is widely used in clinics,and its assessment of the heart's mechanical structure and systolic function is indispensable.Its advantages are mainly reflected in the simple and convenient operation,low cost,non-invasive examination,high repeatability,can intuitively reflect the basic function of the heart,to facilitate the evaluation of clinical conditions.Among them,transthoracic ultrasound can meet the needs of general examination,but it is affected by the receptors' position and the patient's perforation,and often the image quality is not high.In recent years,with the development of transesophageal real-time three-dimensional ultrasound technology,the three-dimensional structure of the mitral valve can be clearly displayed in patients with poor body position and poor sound transmission.As an advanced quantitative analysis software,MVQ can perform quantitative analysis of mitral valve in real-time or offline state.Functional mitral regurgitation is usually considered to be closely related to left ventricular remodeling.Left ventricular enlargement leads to the appearance of functional regurgitation of the mitral valve.Long-term functional mitral regurgitation then promotes enlargement of the left atrium.Patients with atrial fibrillation often have enlarged left atrial accompanied by functional mitral regurgitation,but the left ventricle is not always enlarged,and the role of the left atrium in functional mitral regurgitation is insufficient.Changes in the ring and leaflets have little effect on the degree of regurgitation.Therefore,this study was to investigate the effect of left atrial size in atrial fibrillation on functional regurgitation of mitral valve,and to explore the role of mitral annulus and leaflet structure in it.Objective Transesophageal three-dimensional echocardiography study of the influence of structural changes in mitral valve on the degree of regurgitation in patients with atrial fibrillationMethods Sixty-six patients were selected for electrophysiological examination and radiofrequency ablation in our hospital.According to preoperative electrocardiogram was divided into paroxysmal atrial fibrillation,persistent atrial fibrillation,non-atrial fibrillation control three groups,transthoracic two-dimensional ultrasound examination were performed to obtain LAD,LVD,mitral valve anti-flow,except for valvular heart disease,left ventricle Expansion,congenital and other cases.According to the degree of mitral regurgitation,it was divided into three groups: slight regurgitation,mild regurgitation,and moderate regurgitation.Three-dimensional ultrasonography of the esophagus was performed and mitral valve quantification was performed using MVQ software to obtain mitral valve parameters such as DAP,DAIPm,H,?NPA,?ANT,and ?POST.Results 1.Differences in LAD and DAP were statistically significant under different rhythms;2.There was a significant difference between DAIPm and H between control group and persistent AF group and control group and paroxysmal AF group(P<0.05).There was no significant difference in DAIPm,H between paroxysmal atrial fibrillation and persistent AF(P>0.05).3.NAP,ANT,?POST persistent atrial fibrillation,paroxysmal atrial fibrillation,the difference between the control group was not statistically significant(P> 0.05).4.There was a significant positive correlation between left atrial internal diameter and anterior anterior-posterior diameter of the annulus,annulus height,anteroposterior diameter,and posterior leaf angle.There was no significant correlation between left atrial diameter and ?NPA and ?ANT.5,DAP,DAIPm mild group and moderate group difference was statistically significant;H,?NAP,?ANT no difference between the three groups was not statistically significant;?POST between the three groups were statistically significantConclusion.The increase of the angle of the mitral valve posterior leaf in patients with atrial fibrillation often predicts an increase in functional mitral regurgitation,and the angle of the posterior mitral valve has a certain significance for assessing the degree of regurgitation. |
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