三维超声心动图测定正常人及二尖瓣病变伴或不伴房颤患者左心耳容量及其收缩功能  

Assessment of Left Atrial Appendage Function in Normal Person and Mitral Valve Diseased Subject with Three dimensional Echocardiography

作　　者：李越[1] Herman FJ Mannaerts OttoKamp Gabriel Valocik CeesA Visser 

机构地区：[1]北京市中国人民解放军总医院超声科,100853 [2]荷兰阿姆斯特丹自由大学医院心内科及心血管研究所

出　　处：《中国超声医学杂志》2000年第4期268-273,共6页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨三维超声心动图评价左心耳功能的价值。方法 :采用三维超声心动图对 5 2例正常人及二尖瓣病变伴或不伴心房纤颤患者测定左心耳容量及其收缩功能 ,并与二维超声心动图和多普勒超声心动图比较。结果 :根据左心耳容量测定计算出的左心耳射血分数 (EFv)与左心耳峰值血流排空速度 (Pev)相关良好 (r=0 .818,P<0 .0 1) .根据左心耳面积测定计算出的左心耳射血分数 (EFa)与 Pev的相关性低于前者 (r=0 .744 4,P<0 .0 1)。将所有患者的 EFv与 EFa进行比较 ,虽然两者间未见明显差异 (P>0 .0 5 ) ,但在重复性检验中 EFa的范围和两测量数值之差的均数加减标准差都大于 EFv的相应数值 ,左心耳容量在正常人明显小于有二尖瓣病变的患者 ,而收缩功能则前者明显高于后者 (P值均 <0 .0 1) .在相同二尖瓣病变患者之间进行比较 ,合并房颤者左心耳容量大于窦性心率者 ,而左心耳收缩功能则前者低于后者 (P值均 <0 .0 5 )。另外 ,二尖瓣病变合并房颤者的左心耳自发性“超声造影”发生率高于窦性心率者。结论 :用三维超声心动图测量左心耳容量和评价其收缩功能是可行的 ,评价左心耳功能时较二维超声心动图更准确 ,二尖瓣病变患者的左心耳容量增加 ,收缩功能减低 ,常伴左心耳自发性“超声造影”,上述改变在合并房颤者更?Objective:To eveluate the feasibility of 3DE assessment of left atrial appendage(LAA)function.Methods:Fifty two persons including normal and mitral valve diseased with or without atrial fibrillation(Af)were studied by three dimensional echocardiography(3DE),two dimensional(2DE)and Doppler echocardiography.Results:The LAA ejection fraction derived from LAA volume(EFv)had a good correlation with the LAA peak emptying flow velocity(Pev)(r=0 818, P <0 01).The correlation of LAA ejection fraction derived from LAA area(EFa)with Pev lower than EFv with Pev( r =0 7444, P <0 01).Although no significant difference was found between EFv and EFa( P >0 05),the range and paired differences of EFv were lower than the counterpart of EFa in intra and inter observe study.In patients with mitral valve disease,the left atrial appendage(LAA)volume was larger,LAA function was lower than normal( P <0 05).Compared between the patients in mitral valve disease with and without Af the above changes were more obvious in later( P <0 05).The percentage of spontaneous echo contrast(SEC)in LAA was also higher in later than previous.Conclusion:3DE was feasible for LAA volume and function evaluation.compared with 2DE,it improves the accuracy of LAA mechanical function assessment.Mitral valve disease caused LAA volume increase and LAA function depression,which often accompanied with SEC,the above changes even more obvious in mitral valve disease patients with fibrillation.

关 键 词：三维超声心动图 左心耳功能 二尖瓣病变 房颤 

分 类 号：R445.1[医药卫生—影像医学与核医学]