超声心动图评价阵发性心房颤动患者射频消融术前后左心房功能变化  

Evaluating the change of left atrial function in the patients with paroxysmal atrial fibrillation underwent radiofrequency catheter ablation using echocardiography

作　　者：张晓玲[1] 荣昊[2] 尚艳文[1] 唐红[1] 

机构地区：[1]四川大学华西医院心内科,成都610041 [2] 四川省肿瘤医院胸外科

出　　处：《中华超声影像学杂志》2014年第4期293-296,共4页Chinese Journal of Ultrasonography

摘　　要：目的 应用实时三平面超声心动图（RT-3PE）和定量组织速度成像（QTVI）技术评价阵发性心房颤动患者经导管射频消融术（RFCA）前后左心房结构和功能的改变.方法 对82例首次行RFCA的阵发性心房颤动患者,留取RFCA术前1周内及术后1、3、6个月窦性心律状态下的常规及三切面（tri-plane）超声图像进行脱机分析.测量左心房前后径、上下径及左右径（LADap、LADml、LADsi）;测量二尖瓣血流频谱峰值流速及比值（E峰、A峰、E/A）,以及肺静脉血流频谱峰值流速及比值（S峰、D峰、Ar波、S/D）.应用Tri-plane法测量左心房最大容积、收缩期前容积、最小容积（LAVmax、LAVp、LAVmin）,并计算左心房被动射血分数（LAPEF）、主动射血分数（LAAEF）、总射血分数（LATEF）及扩张指数（LAexpI）,计算左心房6个壁的平均峰值速度（Vs、Ve、Va）.结果 与术前相比,术后3、6个月LADap减小（P＜0.05）;术后3个月A峰增高,E/A比值减低（P＜0.05）;术后6个月除A峰增高,E/A比值减低外,S峰增高,D峰减低,S/D增高（P＜0.05）;术后3个月LAVmin减小,LAAEF、LATEF增高（P＜0.05）;术后6个月左心房容积均减小,LAAEF及LATEF增高（P＜0.05）;术后3、6个月左心房壁平均Va增高（P＜0.05）.结论 RFCA术后1个月左心房重构及功能处于缓慢恢复期,术后3、6个月患者的左心房重构及功能得到一定程度的改善.Objective To evaluate the change of left atrial（LA） volume and function in patients with paroxysmal atrial fibrillation （PAF） after catheter ablation using real-time tri-plane echocardiography （RT-3PE） as well as quantitative tissue velocity imaging （QTVI）.Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter （LADap）,LA mediolateral diameter （LADml） and LA superior-infra diameter （LADsi）,early and late diastolic transmitral flow velocity and ratio （E,A and E/A）,the peak velocity of pulmonary vein and ratio （S,D,Ar,S/D）,the maximum volume of the left atrium （LAVmax）,the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram（LAVp）,the minimum volume of the left atrium （LAVmin）,LA passive emptying fraction （LAPEF）,LA active emptying fraction （LAAEF）,LA total emptying fraction （LATEF）,LA expansion index （LAexpI）,average peak velocity of six wall of the left atrium （Vs,Ve,Va）.Results After 3,6 months,LADap decreased significantly（P 〈 0.05） ;3 months of follow up,peak A increased,E/A ratio decreased （P 〈0.05）;6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased（P 〈0.05） ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased （P 〈0.05）;6 months of follow up,LA volume decreased,LAAEF and LATEF increased （P 〈0.05）;3,6 months of follow up,the average Va increased（P 〈0.05）.Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.

关 键 词：超声心动描记术 心房颤动 导管消融术 心房功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.75[医药卫生—诊断学]