左心耳超声心动图学指标与阵发性心房颤动药物治疗后复发的关系  

Relationship Between Left Atrial Appendage Ultrasound Derived Index and Atrial Fibrillation Recurrence in Paroxysmal Atrial Fibrillation Patients Undergoing Antiarrhythmic Drug Therapy

作　　者：张晨峰[1] 李静[1] 刘伟[1] 邢颖 胡莹[1] 于丽娜[1] 杨颖[1] 张明[1] 张新文 ZHANG Chen-feng;LI Jing;LIU Wei;XING Ying;HU Ying;YU Li-na;YANG Ying;ZHANG Ming;ZHANG Xin-wen(Department of Cardiology,Baoding First Central Hospital,Baoding（071000）,Hebei,China)

机构地区：[1]保定市第一中心医院心内科,河北省071000

出　　处：《中国循环杂志》2018年第8期777-780,共4页Chinese Circulation Journal

摘　　要：目的:评价经食管超声心动图评估的左心耳形态和功能等指标与阵发性心房颤动(房颤)经药物治疗后复发的关系。方法:随机选取2015-06至2017-06在我院收治的73例阵发性房颤患者,并通过经食管实时三维超声心动图测得左心耳开口面积、左心耳长径、左心耳分叶数目、左心耳容积、左心耳射血分数、左心耳血流排空速度等指标。比较随访12个月内房颤复发与无复发两组患者各指标的变化并明确其中危险因素。结果:随访12个月时,共21例复发房颤。与房颤无复发组患者相比,复发组患者的左心耳分叶数目更多,左心耳容积更大,左心耳射血分数和血流排空速度更低(P均<0.05)。多因素分析显示,CHA2DS2-VASc评分(OR=2.71,95%CI:1.84~3.46)、血浆B型利钠肽(BNP)(OR=2.74,95%CI:1.45~4.18)、左心房容积(OR=1.49,95%CI:1.27~1.99)、左心耳分叶数目(OR=2.08,95%CI:1.65~2.55)、左心耳容积(OR=1.97,95%CI:1.73~3.46)均是房颤复发的独立危险因素。结论:CHA2DS2-VASc、BNP、左心房容积、左心耳分叶数目、左心耳容积是房颤复发的独立危险因素。左心耳的分叶数目和容积对房颤复发有预测价值。Objectives： To evaluate the association between the morphologic and functional parameters of left atrial appendage（LAA） derived by real-time 3 D transesophageal echocardiography（RT-3D TEE） and atrial fibrillation（AF） recurrence in paroxysmal AF patients under medication treatment.Methods： A total of 73 cases of patients hospitalized with paroxysmal atrial fibrillation in our hospital from June 2015 to June 2017 were randomly selected, left atrial appendage orifice area, length（LAA-L）, number of Lobes（LAA-lobes）, volume（LAA-V）, ejection fraction（LAA-EF） and velocity（LAA-v） were derived from RT-3D TEE examination. All patients were followed up for 12 months, and divided into no recurrence group and AF recurrence group. Above parameters were compared between the groups and risk factors for AF recurrence were analyzed.Results：AF recurrence occurred in 21（28.77%） patients during 12 months follow-up. Number of the LAA-lobes was significantly higher and LAA-V was significantly larger, while the LAA-EF and LAA-v were significantly lower in recurrence group than in non-recurrence group（all P〈0.05）. Multivariate regression analysis revealed that CHA2 DS2-VAsc（OR=2.71,95%CI： 1.84-3.46）,BNP level（OR=2.74,95%CI：1.45-4.18）, left atrial volume（OR=1.49, 95%CI： 1.27-1.99）, left atrial appendage volume（OR=1.97,95%CI： 1.73-3.46）and number of LAA lobes（OR=2.08,95%CI： 1.65-2.55）were the independent risk factors of AF recurrence in this patient cohort.Conclusions： Our results indicate that CHA2 DS2-VAsc score,BNP level, left atrial volume, left atrial appendage volume are the independent risk factors of AF recurrence. The number of LAA lobes and left atrial appendage volume could also predict the AF recurrence in this patient cohort.

关 键 词：左心耳 经食管超声心动图 心房颤动复发 

分 类 号：R541[医药卫生—心血管疾病]