心房追踪技术对心房颤动患者右心房功能的评价  

Evaluation of right atrial function with atrial volume tracking method in patients with Atrial fibrillation

作　　者：王茜[1] 张文华[1] 夏稻子[1] 丁彦春[2] 刘莉红[1] 关晓韵 贾婷婷[1] 

机构地区：[1]大连医科大学附属第二医院超声科,116027 [2]大连医科大学附属第二医院心内科,116027

出　　处：《中国心血管杂志》2014年第1期12-15,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的应用心房追踪技术(AVT)评价高血压心房颤动(HAF)和孤立性心房颤动(LAF)患者右心房整体结构及功能的变化。方法实验组为60例心房颤动患者,包含LAF组36例,HAF组24例(左心室结构正常),对照组为30名健康成人,分别应用M型超声测量:舒张末期室间隔厚度(IVSTd)、舒张末期左心室后壁厚度(LVPWTd),左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD),右心室舒张末期内径(RVEDD),以校正立方体积法(Teich)计算左心室射血分数(LVEF);应用二维超声测量患者收缩末期右心房上下径(RAD1)、横径(RAD2),收缩末期左心房前后径(LAD1)、上下径(LAD2)、横径(LAD3);应用AVT测量右心房最大面积(RAAmax)、右心房最大容积(RAVmax)、右心房最小容积(RAVmin),计算右心房排空分数(RAEF),收缩期右心房充盈速率峰值(dv/dtS)、舒张早期右心房排空速率峰值(dv/dtE)。结果与健康对照组相比,心房颤动组的RAD1、RAD2、RAAmax、RAVmax、RAVmin、dv/dtE、LAD1、LAD2、LAD3明显升高,RAEF、dv/dtS明显减低(均为P<0.05),LVEDD、LVESD、RVEDD、IVSTd、LVPWTd、LVEF各组间差异无统计学意义(均为P>0.05)。与HAF组相比,LAF组RAD1、RAD2、RAAmax、RAVmax、RAVmin、dv/dtE明显升高,LAD1、LAD2、LAD3、RAEF、dv/dtS明显减低(均为P<0.05)。结论 LAF患者右心房结构和功能损害程度较HAF患者更为明显。而AVT是一种简捷、准确评价右心房功能的方法。Objective To evaluate the structure and function of right atrium （RA） in patients with hypertension atrial fibrillation （HAF） and lone atrial fibrillation （LAF） by AVT. Methods Sixty patients with atrial fibrillation were divided into LAF group （ n = 36 ） and HAF group （ n = 24 ） . Thirty normal volunteers served as control group. Interventricular septum thickness at end diastole （IVSTd）, left ventricular posterior wall thickness at end diastolic （ LVPWTd ） , left ventricular end-diastolic dimension （LVEDD）, left ventricular end-systolic dimension （LVESD）, right ventricular end-diastolic dimension （RVEDD）were evaluated by M-mode ultrasound. Left ventricular ejection fraction （LVEF） was calculated by Teich method. Echocardiographic evaluations included RA major dimension （RAD1）, RA minor dimension （RAD2）, LA diameter （LAD1）, LA major dimension （LAD2） and LA minor dimension （LAD3）. RA maximal area （RAAmax） , RA maximal volume （RAVmax） , RA minimal volume （RAVmin） , systolic RA filling rate （dv/dtS） and early diastolic RA emptying rate （dv/dtE） were derived using AVTM. Then the RA emptying fraction （ RAEF ） was calculated. Results Compared with the values in controlgroup ,the RAD1, RAD2, RAAmax, RAVmax, RAVmin and dv/dtE, LAD1, LAD2, LAD3 were significantly higher and RAEF, dv/dtS were significantly lower in atrial fibrillation group （ all P 〈 0. 05 ）. There were no significant differences in LVEDD, LVESD, RVEDD, IVSTd, LVPWTd and LVEF between groups （ all P 〉 0.05）. RAD1, RAD2, RAAmax, RAVmax, RAVrnin, dv/dtE were significantly higher and LAD1, LAD2, LAD3, RAEF, dv/dtS significantly lower in LAF group compared with HAF group （ all P 〈 0.05 ） . Conclusions Compared with HAF patients, RA function is significantly impaired in patients with LAF. AVT can evaluate RA function accurately and simply.

关 键 词：心房颤动 超声心动描记术 右心房功能 心房追踪技术 

分 类 号：R541.75[医药卫生—心血管疾病]