Author/Editor		Verovnik, Franc
Title		Ehografska evalvacija mehanske funkcije levega preddvora po konverziji atrijske fibrilacije
Translated title		Echographic assessment of left atrial mechanical function after conversion of atrial fibrillation
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 1
Publication year		1997
Volume		str. 5-10
Language		slo
Abstract		Background. After successful cardioversion of atrial fibrillation sinus rhythm occurs at once. Full recovery of atrial mechanical activity may not occur immediately after conversion. We aimed to study the time course recovery of this activity using echocardiographic studies. Methods. In a group of 21 patients with nonvalvular atrial fibrillation of various duration after a successful conversion to sinus rhythm we determined, using echocardiographic studies, the left atrial dimensions, lef ventricular fractional shortenings, peak velocities of transmitral flow (peak E and peak A), and velocity-time integrals of early and atrial filling velocity-time profiles. Patients were examined immediately after conversion, one week, one month, and three months after cardioversion if they remained in sinus rhythm. Results. 5 out of 21 patients reverted to atrial fibrillation at the time of study. The dimensions of atria were significantly greater than those of patients who remained in sinus rhythm. In the later group of patients the values of left ventricular fractional shortenings slightly increased in period of 1 to 4 weeks after conversion, and so did the values of peak A, compared to the values in the first 24 hours after conversion. At that time the ratio peak A to peak E was significantly reduced due to the increased peak A. Atrial filling fraction (= % of atrial contribution to total left ventricular filling) also significantly increased. In the group of 5 patients who reverted to atrial fibrillation these changes were not statistically significant in 1 to 4 weeks. Conclusions. The data suggest that it takes a cetain time for the left atria to restore full strength after successful conversion of atrial fibrillation to sinus rhythm. (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Po uspešni konverziji atrijske fibrilacije se takoj vzpostavi sinusni ritem. Mehanska funkcija preddvorov pa se ne popravi neposredno po konverziji, temveč šele po določenem času, kar skušamo v raziskavi potrditi s pomočjo ehografskih preiskav. Metode. Skupini 21 bolnikov z nevalvularno atrijsko fibrilacijo različnega trajanja smo po uspešni konverziji v sinusni ritem s pomočjo ehografskih preiskav določili dimenzije levih preddvorov, deleže skrajšave levega prekata, največje hitrosti obeh valov transmitralnega pretoka (E in A) ter integrale hitrosti in časa obeh valov. Preiskave so bile opravljenje takoj po konverziji, nato pa še en teden, en mesec in tri mesece kasneje, če je pri bolnikih ostal sinusni ritem. Rezultati. Pet bolnikov od 21 je v času raziskave doživelo recidiv atrijske fibrilacije. Dimenzije njihovih preddvorov so bile pomembno večje kot pri bolnikih brez recidiva. Bolnikom s trajnim sinusnim ritmom so se pomembno povečali deleži skrajšave levega prekata in največje hitrosti valov A 1 do štiri tedne po konverziji v primerjavi z vrednostimi prvih 24 ur po posegu. V tem času se je pomembno zmanjšalo razmerje med največjimi hitrostmi valov A in valov E (največji A/E) na račun povečanih hitrosti valov A. Hkrati se je s tem povečal delež aktivne atrijske polnitve prekatov v diastoli zaradi izboljšane krčljivosti preddvorov. Pri skupini bolnikov z recidivom atrijske fibrilacije ni prišlo do pomembnih sprememb omenjenih parametrov en ali štiri tedne po konverziji. Zaključki. Z raziskavo smo potrdili, da se pri nekaterih bolnikih vzpostavi normalna mehanska funkcija preddvorov šele po določenem času po uspešni konverziji atrijske fibrilacije v sinusni ritem. (Izvleček prekinjen pri 2000 znakih.)
Descriptors		ATRIAL FIBRILLATION ATRIAL FUNCTION, LEFT HEART ATRIUM ADULT MIDDLE AGE AGED PROSPECTIVE STUDIES ELECTRIC COUNTERSHOCK ECHOCARDIOGRAPHY, DOPPLER, PULSED