【Abstract】Aim To construct a prediction model based on functional mitral regurgitation (FMR) in patients with paroxysmal atrial fibrillation (PAF) for predicting atrial fibrillation recurrence after the post-circular pulmonary vein radiofrequency ablation (CPVA). Methods We retrospectively analyzed 289 patients with PAF who underwent CPVA for the first time . The patients were randomly divided into modeling group and verification group at the ratio of 75:25. In the modeling group, the multivariate logistic regression was used to analyze and construct a prediction model for post-CPVA recurrence in PAF patients, which was then validated in the verification group. Results (1) After 3-6 months of follow-up, the patients were divided into sinus rhythm group (252 cases) and recurrence group (24 cases); (2) In the modeling group, the age, LAD(left atrial diameter) and degree of MR (mild, moderate, severe) were higher in recurrence group than that of the sinus rhythm group, and the left atrial appendage emptying velocity (LAAV) was lower in recurrence group (all P<0.05). (3) A model for predicting the recurrence of PAF after radiofrequency ablation was constructed in the modeling group. The equation was: Logit(P) = -3.253 + 0.092 × age + 1.263 × mild MR + 2.325 × moderate MR + 5.111 ×severe MR - 0.113 × LAAV. The area under the curve (AUC) of the model was 0.889 in modeling group and 0.866 in verification group, and the difference was not statistically significant ( P>0.05). Conclusion: The prediction model of atrial fibrillation (AF) recurrence after CPVA in PAF patients has good predictive efficacy, high specificity and accuracy.

Objective: The purpose of this study is to evaluate the changes of LA size and function by real-time 3D echocardiography (RT-3DE), and provide a better understanding about their effects on treatment and prognosis. Methods: Ten Bama miniature pigs were used for modeling STEMI. Images were obtained by RT-3DE at multiple time points. From the LA volume-time relation curve, the LA volume (LAV) and functions (storage, channel, and active emptying) at different phases were calculated. Blood samples were obtained for measurements of NT-proBNP, creatine kinase-MB(CK-MB) and cardiac Troponin-I(cTn-I). Results: (1) LAVmax, LAVmin and LAVpre-a were all increased with time. (2) The LA expansion index was the most sensitive index of LA functional change. It increased (p< .05 vs. baseline) at the 1st day after STEMI (acute phase), and was correlated with diastolic function E/E’ (p< .05), as shown by univariate correlation analysis. (3) On the 28th day after STEMI, the active emptying percentage of total emptying (AE) showed a continuously increasing trend (p< .05), and was correlated with VTILVOT (time-velocity integral of left ventricular outflow tract) (p< .05). Conclusions: During the acute phase after STEMI, LA volume changed in order to increase LV preload. After STIMI, the storage function of LA was the first to change, while active contractile function was significantly enhanced during subacute phase. With the accurate measurement of LA function with RT-3DE, our study will help improving the therapeutic target setting and pharmacologic interventions, which may enhance the clinical outcomes of STEMI patients.