实时三维经食管超声心动图评价非瓣膜病性心房颤动患者左心耳容积、功能与自发性显影的关系  

Assessment of the association of left atrial appendage volume and function with spontaneous echo contrast using real-time three-dimensional transesophageal echocardiography in patients with nonvalvular atrial fibrillation

作　　者：金惠红[1] 赵博文[2] 朱文军[1] 周娟[1] 王志勇[3] JIN Huihong;ZHAO Bowen;ZHU Wenjun(Department og Diagnostic Ultrasoud,the First Hospital of Jiaxing,Jiaxing 314000,China)

机构地区：[1]嘉兴市第一医院超声科,314000 [2]浙江大学医学院附属邵逸夫医院超声科 [3]嘉兴市第一医院心内科,314000

出　　处：《心电与循环》2016年第6期407-410,共4页Journal of Electrocardiology and Circulation

基　　金：嘉兴市科技计划项目(2013AY21042-9)

摘　　要：目的应用实时三维经食管超声心动图(RT-3D TEE)评价非瓣膜病性心房颤动患者左心耳容积和功能变化与自发性显影的关系。方法经RT-3D TEE检查的心房颤动患者58例,分为左心耳无自发性显影(无SEC组)、少量自发性显影(少量SEC组)及明显自发性显影或血栓形成(明显SEC组)。对照组22例,为经RT-3D TEE检查的正常窦性心律者。测定和比较4组患者RT-3D TEE获得的左心耳容积及功能参数[左心耳舒张末期最大容积(MEDV)、左心耳收缩末期最小容积(MESV)、左心耳开口最大面积(OAmax)、左心耳开口最小面积(OAmin)、左心耳开口舒张末期最大直径(DODmax)、左心耳开口收缩末期最大直径(SODmax)、左心耳的排空指数(LAAEI)]。结果左心耳容积与功能参数均呈正态分布。4组病例的参数中,方差齐性检测结果显示OAmax、OAmin、DODmax、SODmax为方差齐,MEDV、MESV、LAAEI为方差不齐。MEDV、MESV、OAma x、OAmin、DODma x、SODma x随着自发性显影的加重而呈增高趋势,LAAEI随着自发性显影的加重而呈下降趋势。结论心房颤动患者左心耳自发性显影程度与左心耳容积和功能变化相关。Objective To evaluate the association of the volume and function of left atrial appendage (LAA) withspontaneous echo contrast (SEC) in patients with non-valvular atrial fibrillation (AF) by real-time three-dimensionaltransesophageal echocardiography(RT-3DTEE). Methods 58 patients with AF underwent RT-3D TEE and were dividedinto no SEC group, mild SEC group, obvious SEC group and thrombosis group based on LAA SEC. Control group, 22patients with sinus rhythm were examined by RT-3D TEE. The maximum end-diastolic volume (MEDV), the minimumend-systolic volume (MESV), the maximum orifice area (OAmax), the minimum orifice area (OAmin), the maximumend-diastolic orifice diameter (DODmax), the maximum end-systolic orifice diameter (SODmax ) of LAA and LAAemptying index (LAAEI)] were measured using RT-3DTEE and compared among the four groups. Results The volumeand function of LAA obeyed normal distribution. Homogeneity test of variance showed that OAmax、OAmin、DODmax andSODmax were homoscedasticity, while MEDV, MESV and LAAEI exhibited heterogeneity in all 4 groups. MEDV, MESV,OAmax, OAmin, DODmax and SODmax showed a trend toward increase, while LAAEI showed a tread toward decrease asSEC increased. Conclusion The extent of LAA SEC is related to the changes of volume and function of LAA in patientswith AF.

关 键 词：实时三维经食管超声心动图 左心耳 心房颤动 自发性显影 

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