经食管超声心动图对非风湿性心房颤动转复前后左心耳血流频谱曲线的研究  

Study of left atrial appendage flow spectra in precardioversion and postcardioversion by TEE in nonrheumatic atrial fibrillation

作　　者：吴长君[1] 杨敬源[2] 肖竹影[1] 

机构地区：[1]哈尔滨医科大学附属第一医院超声科,150001 [2]哈尔滨医科大学预防保健医院超声科

出　　处：《中华超声影像学杂志》2002年第5期273-275,共3页Chinese Journal of Ultrasonography

摘　　要：目的　探讨非风湿性心房颤动 (简称房颤 )转复前后左心耳血流频谱曲线的类型及其相应的血流动力学特点。方法　应用经食管超声心动图 (TEE)对 60例非风湿性房颤患者转复前后的左心耳血流频谱曲线进行研究。结果　非风湿性房颤左心耳血流频谱曲线分 3种类型 :①持续整个心动周期的明确且不规则的充盈及排空波 ;②不连续的低小充盈及排空波 ;③持续的低流速波。从第一到第三种类型的演变过程中 ,左心房、左心耳内径逐渐扩大 ,功能逐渐减低 ,自发显像 (SEC)程度和血栓发生率逐渐增加。转复窦性心律后左心耳血流频谱曲线为规则收缩与舒张的窦性心律血流频谱曲线 ,但转复后的左心耳峰值血流速度 (LAA PEV )为 (2 3± 10 )cm /s ,低于转复前的 (3 0± 12 )cm /s (P <0 .0 0 1) ;左心房及左心耳新出现SEC者 8例 ,SEC密度增加者 11例。结论　非风湿性房颤左心耳的血流频谱曲线较好地反映左心房及左心耳功能 ,在一定程度上反映了左心室的舒张功能。房颤转复窦性心律后 ,左心耳血流频谱曲线恢复窦性 ,但左心耳功能出现“顿抑”。Objective To evaluate the flow spectra and the hemodynamic characteristics of left atrial appendage(LAA) of patients with nonrheumatic atrial fibrillation(NRAF) in precardioversion and postcardioversion.Methods LAA flow spectra examinations were preformed by TEE in 60 patients with NRAF before cardioversion and after cardioversion.Results Three different flow spectra were observed.①Irregular but well defined LAA emptying and filling Doppler signals were recorded within each cardiac cycle; ②Very low flow signals were recorded and sometimes,no signals at all could be detected; ③Prolonged low velocity wave was recorded.In the process of changing from the first pattern to the third pattern,left atrial and left atrial appendage were enlarged,left atrial function and left atrial appendage function were decreased,spontaneous echocardiographic contrast(SEC) and thromboembolism event were increased.LAA flow spectra converted to a organized contraction and diastole patterns after successful cardioversion,left atrial appendage peak emptying velocity(LAA PEV) [(23±10)cm/s] was lower than that before cardioversion [(30±12)cm/s](P< 0.001 ).SEC could be generated in 8 patients,intensified in 11 patients.Conclusions LAA flow spectra can reflect left atrial function, LAA function and left ventricular diastolic function.LAA flow spectrum after successful cardioversion converted to a sinus rhythm pattern,LAA function developed 'stunning

关 键 词：经食管 超声心动描记术 心房颤动 左心耳 

分 类 号：R540.45[医药卫生—心血管疾病]