Correlation Between Persistent Atrial Fibrillation Symptoms Left Atriography Aontrast Medium Retention

Objective:To investigate the effect of left atriography aontrast medium retention on symptom in persistent atrial fibrillation.Methods:A total of 93 patients with persistent atrial fibrillation hospitalized at Bethune Hospital affiliated to Shanxi Medical University from May 2020 to August 2022 were selected as subjects.The clinical symptoms were evaluated and graded according to the Atrial Fibrillation Severity Scale of the Canadian Cardiovascular Society.Age,gender,duration of atrial fibrillation,body mass index,whether hypertension,diabetes,and coronary heart disease were recorded.Extracted the first blood sample after admission:soluble growth stimulating expression gene 2 protein,B-type natriuretic peptide,triglycerides,and total cholesterol.Left atrial anteroposterior diameter and left atrial ejection fraction were measured by echocardiography.Extracted left atrial angiography image data during radiofrequency ablation,record the patient’s heart rate,contrast agent development retention time in the left atrium,and the cardiac cycle of contrast agent evacuation,and study the correlation between various indicators and symptom grading.Results:(1)The median age of 93 patients was 64.00(57.00,70.50)years,50 men(53.2%),the course of atrial fibrillation was 9.5(1.4,45.0)months,body mass index was 24.34(23.09,27.27),53 patients(56.4%)were complicated with hypertension,18 patients(19.1%)were complicated with diabetes,31 patients(33%)were complicated with coronary heart disease,9 patients(9.6%)were classified as Grade 0,7 patients(7.4%)were classified as Grade 1,26 patients(27.7%)were classified as Grade 2,43 patients(45.7%)were classified as Grade 3,and 8 patients(8.5%)were classified as Grade 4.The results of the first assay after admission:soluble growth stimulating gene 2 protein:12.00(9.70,22.00),B-type natriuretic peptide:145.00(88.00268.50),triglyceride:1.31(1.03,1.785),total cholesterol:3.75(3.005,4.475).Echocardiographic examination results:left atrial anteroposterior diameter:37.83±6.58,left atrial ejection fraction:40.21±9.82.Left atrial angiography data during radiofrequency ablation:heart rate80.34±16.28 beats/minute,contrast agent emptying time in the left atrium 1.50(1.21,1.86)seconds,and contrast agent emptying cardiac cycle 1.84±0.63.(2)Spearman correlation test was performed to evaluate the correlation between various indicators and symptom grading.The results showed that the left atrial contrast agent retention time(r_s=0.561,P<0.05),cardiac cycle(r_s=0.444,P<0.05),and B-type natriuretic peptide levels(r_s=0.376,P<0.05)were significantly correlated with symptom grading.(3)Incorporating soluble growth stimulating gene 2 protein,B-type natriuretic peptide,left atrial ejection fraction contrast agent retention time,and cardiac cycle,a multivariate logistic regression model was constructed.It was found that as B-type natriuretic peptide levels,contrast agent emptying time,and the number of cardiac cycles used for emptying increased,the symptom grade also increased,It has statistical significance(OR=1.004,95%CI:0.000,0.007,P=0.025;OR=15.394,95%CI:0.896,4.572,P=0.004;OR=1.044,95%CI:1.161,7.452,P=0.027).(4)The ROC curve analysis of B-type natriuretic peptide,contrast agent retention time,and cardiac cycle showed that:B-type natriuretic peptide,evacuation time,and area under the cardiac cycle curve were 0.810,0.785,and 0.672,respectively,with statistical significance(P<0.05).Among them,the B-type natriuretic peptide cutoff value was278pg/m L,the evacuation time cutoff value was 1.41 seconds,and the cardiac cycle cutoff value was 1.5 cycles.Conclusion:(1)Patients with persistent atrial fibrillation who have long atrial blood flow emptying times,poor left atrial function,and elevated B-type natriuretic peptide levels may have more significant symptoms of atrial fibrillation.(2)In clinical practice,more comprehensive clinical management can be carried out for patients with prolonged left atrial contrast agent evacuation during surgery but currently with no obvious symptoms,to prevent possible severe symptoms.