经导管线性消融术治疗阵发性房颤对左房近期功能的影响  

Effects of Left Atrial Linear Ablation for Paroxysmal Atrial Fibrillation on Lately Left Atrial Mechanical Function

作　　者：周青[1] 郭瑞强[1] 陈金玲[1] 江洪[2] 

机构地区：[1]武汉大学人民医院超声影像科,武汉市430060 [2]武汉大学人民医院心内科

出　　处：《中国超声医学杂志》2007年第4期275-277,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用超声心动图评价左房线性消融术治疗阵发性房颤对近期左房功能的影响。方法28例因阵发性房颤行线性消融的患者，于术前和术后2～3个月行超声心动图检查。通过二维超声测量左房容积和排空能力，组织速度成像检测二尖瓣前瓣环舒张晚期峰值速度Va，应变率显像检测左房壁舒张晚期峰值应变率SRa，来观察左房储存功能、管道功能和辅泵功能的变化。结果消融后左房收缩末容积和左房内径无明显改变；左房管道容积和舒张末容积增高；左房分数、左房射血力、二尖瓣血流VA、二尖瓣环Va显著降低；左房平均SRa和局部各壁SRa均显著降低，尤其以后壁和侧壁降低最明显。结论线性消融术对近期左房局部和整体功能均存在一定程度的不利影响。Objective To evaluate the effects of left atrial linear ablation guided by Carto mapping system for paroxysmal atrial fibrillation on lately left atrial mechanical function by echocardiography. Methods Twenty-eight cases who underwent linear ablation procedure for paroxysmal atrial fibrillation accepted echocardiographic examination to assess the left atrial （LA） mechanical function before and two or three months after ablation. Indices included LA volume and evacuation ability detected by routine two-dimensional echo and mitral annular motion, A wave and late-diastolic strain rate of individual LA wall （SRa） detected by tissue velocity technique and strain rate imaging. The changes of reservoir function, booster pump and conduit function of LA before and post-ablation were well assessed. Results After ablation, the end-systolic volume and LA size had no change, the LA end-diastolic volume and the conduit volume were increased, while the ejection fraction, ejection force of LA, mitral inflow velocity A wave and mitral annular motion A wave were decreased significantly. The mean LA-SRa and individual SRa of LA wall were lowered statistically, especially the LA posterior and lateral wall. Conclusions The linear ablation for atrial fibrillation did have some negative effects on LA local and global mechanical function.

关 键 词：左房功能 线性消融术 超声心动图 阵发性房颤 

分 类 号：R541.75[医药卫生—心血管疾病]