经食管超声心动图对心房颤动时左心耳血流动力学的研究  

Transesophageal pulsed Doppler echocardiographic study of left atrial appendage flow in patients with atrial fibrillation

作　　者：郝恩魁[1] 张薇[1] 葛志明[1] 张运[1] 康维强[2] 孙吉辉[2] 

机构地区：[1]山东大学齐鲁医院心内科,济南250012 [2]青岛市海慈医院心血管病研究所

出　　处：《中华超声影像学杂志》2002年第8期463-466,共4页Chinese Journal of Ultrasonography

摘　　要：目的　研究心房颤动 (房颤 )时左心耳血流动力学的变化及临床价值。方法　使用多平面经食管超声心动图记录并分析 74例房颤患者的左心耳图像、血流频谱及其他相应指标。结果　房颤患者的左心耳最大容积 (Vmax LAA)、左心耳最小容积 (Vmin LAA)均大于窦性心律对照组 ,左心耳射血分数EF LAA、左心耳的最大正向血流速度 (V LAA+ )、最大负向血流速度 (V LAA-)均小于窦律对照组。其中风湿性心脏病轻度二尖瓣狭窄组与重度二尖瓣狭窄组的上述指标与非风湿性心脏病房颤组均有明显差异 ,而风湿性心脏病二组间的上述指标无明显差异。III型左心耳血流频谱易伴随着较严重的左心耳、左心房的自发性回声 (SEC)及血栓形成。结论　多平面经食管超声技术可有效评价房颤时左心耳血流动力学 。Objective To determine the left atrial appendage(LAA) hemodynamics in patients with atrial fibrillation(AF).Methods Seventy four patients with AF were examined by transesophageal echocardiography(TEE) which was classified as three subgroups: group A, nonrheumatic heart disease group;group B, rheumatic mitral stenosis(MS) group with valve area> 1.00 cm 2; group C, rheumatic MS group with valve area< 1.00 cm 2.Results LAA volume was significantly larger,the forward and backward flow velocity of LAA was significantly lower in patients with AF than in patients with sinus rhythm.The above changes were more significant in group B and C than in group A.The morbidity of spontaneous SEC and clot was significantly higher in patients with AF than that in patients with sinus rhythm.Type III flow pattern of LAA was strongly correlated with the presence of SEC and thrombus.Conclusions LAA flow velocity patterns provide an important information of LAA hemodynamics in patient with AF,espescialy in early period of AF.

关 键 词：经食管超声心动图 心房颤动 左心耳 血流动力学 研究 

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