双脉冲多普勒技术对心房颤动患者左心室舒张功能及射频消融术后复发预测的应用研究  

Research of Dual-pulse wave Doppler for left ventricular diastolic function in atrial fibrillation and predicting recurrence after radiofrequency catheter ablation

作　　者：陈凤娇 曲绍辉 李海茹[1] 孙钦亮 田家玮[1] Chen Fengjiao;Qu Shaohui;Li Hairu;Sun Qinliang;Tian Jiawei(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086.China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,150086

出　　处：《中华超声影像学杂志》2018年第7期574-578,共5页Chinese Journal of Ultrasonography

摘　　要：目的探究双脉冲多普勒技术评价心房颤动（房颤）患者左室舒张功能及预测射频消融术后房颤复发的应用价值。方法选取拟行射频消融术的房颤患者67例作为病例组，另选年龄、性别相匹配的窦性心律者47例作为对照组，收集两组研究对象一般临床资料，并行常规超声及双脉冲多普勒检查。对病例组射频消融术后3、6、12个月进行24h动态心电图检查，根据检查结果将房颤患者分为复发组和未复发组。双脉冲多普勒超声参数包括：①二尖瓣舒张早期血流E峰开始时间与二尖瓣环舒张早期e’峰开始时间差值（TE—e’）；②二尖瓣口E峰和组织多普勒（TDI）二尖瓣环室间隔（S）心肌运动峰值速度（e’）、二尖瓣口E峰和组织多普勒二尖瓣环侧壁（L）心肌运动峰值速度（e’）、E／e’（s）及E／e’（L）。对病例组与对照组、房颤复发组与未复发组进行一般临床资料和超声参数对比，用单因素和多因素Logistic回归分析影响射频消融术后房颤复发的因素。结果①病例组E／e’（s）、E／e’（L）和TE—e’高于对照组（均P〈0．05）；②射频消融术后的随访中，21例患者复发（31．34o,4）。复发组TE—e’高于未复发组（P〈0．001），两组E／e’（s）和E／e’（L）差异无统计学意义（均P〉0．05）；③单因素和多因素Logistic回归分析表明，TE—e’是射频消融术后房颤复发的独立预测因素（P=0．001）。结论双脉冲多普勒技术可以用于评估房颤患者左室舒张功能，TE-e’是射频消融术后房颤复发的独立预测因素．Objective To explore the value of parameters obtained by dual-pulse wave Doppler to predict the recurrence of atrial fibrillation （AF） after radiofrequency catheter ablation（RFCA） and the value of the technology to evaluate the left ventricular diastolic function of the AF. Methods Sixty-seven AF patients who were subjected to ablation were selected as the case group, and 47 patients with sinus rhythm were matched as control group. The general clinical data of the case group and the control group was collected, routine ultrasound examination and dual-pulse wave Doppler examination were performed to all of them. A 24-hour Holter examination was performed at 3,6 and 12 months after radiofrequency catheter ablation in the case group, the patients were divided into two groups with and without recurrence according to the results. Dual-pulse wave Doppler parameters included： ①the time interval between the onset of early transmitral flow velocity （E） and that of early diastolic mitral annular velocity （er） （TE-e＇） ;②peak early diastolic transmittal flow velocity （E） and tissue Doppler septal （S） mitrai annular early diastolic velocity （e＇）, peak early diastolic transmitral flow velocity （E） and tissue Doppler lateral （L） mitral annular early diastolic velocity （e＇）, E/e＇ （S） and E/e＇ （L）. The differences between the case group and the control group, and between the recurrent and the non-recurrent group were compared. The factors influencing the recurrence of AF after RFCA were analyzed with univariate and multivariate Logistic regression. Results ③The parameters E/e＇（S）, E/e＇（L） and TE-e＇ of case group were higher than those of control group （all P〈0.05） ;②During follow-up examinations after the ablation, 21 （31.34%） patients recurred. TE e＇ of the recurrence group was higher than that in the nonrecurrence group （ P 〈0.001 ）. The parameters E/e＇ （S） and E/e＇ （L） in the recurrence group had no difference co

关 键 词：超声心动描记术 心房颤动 射频消融术 双脉冲多普勒 复发 

分 类 号：R540.45[医药卫生—心血管疾病] R541.75[医药卫生—内科学]