房颤心律和CHA2DS2-VASc评分与左心耳流速相关性的临床研究  

Clinical Study on the Correlation of Cardiac Rhythm,CHA2DS2-VASc Score with Left Atrial Appendage Velocity in Patients with Atrial Fibrillation

作　　者：孙兰兰[1] 吕秀章[1] 李一丹[1] 叶晓光[1] 姜维[1] 蔡绮哲[1] Sun Lanlan;Lii Xiuzhang;Li Yidan;Ye Xiaoguang;Jang Wei;Cai Qizhe(Department of Echocardiography,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院心脏超声科

出　　处：《中国超声医学杂志》2019年第12期1086-1089,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨非瓣膜性房颤患者心律对左心耳流速的影响,及CHA2DS2-VASc评分和左房应变与左心耳流速的相关性。方法共纳入非瓣膜性房颤患者231例。行经胸超声心动图(TTE)及经食管超声心动图(TEE)检查,测量左心耳排空血流速度(LAA-FV),并应用斑点追踪技术测量整体左房长轴应变(GLALS)。根据TEE检查时患者心律分为房颤心律组和窦性心律组,并分别根据LAA-FV是否减低分为LAA-FV正常组和减低组。结果房颤心律组较窦性心律组LAA-FV明显减低[(29.47±10.91)%vs(55.84±17.16)cm/s,P<0.001]。窦性心律组,LAA-FV与CHA2DS2-VASc评分具有相关性(r=-0.248,P=0.003),CHA2DS2-VASc评分在LAA-FV正常组和减低组差异有显著性[2(1~3)vs 4(2.5~4.3),P=0.007]。GLALS无论在房颤心律组还是窦性心律组都是LAA-FV减低的独立预测因子。结论房颤心律可使LAA-FV明显减低。窦性心律时CHA2DS2-VASc评分与LAA-FV呈负相关性。GLALS对LAA-FV减低有独立预测价值。Objective To investigate the effect of cardiac rhythm on left atrial appendage velocity in patients with non-valvular atrial fibrillation(AF).And to explore the correlation of CHA2DS2-VASc score and left atrial strain with left atrial appendage velocity.Methods A total of 231 patients with non-valvular AF were selected.All patients were performed by transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE).Left atrial appendage emptying flow velocity(LAA-FV)and global left atrial longitudinal strain(GLALS)were measured.Patients were divided into AF group and sinus rhythm(SR)group according to patient′s heart rhythm during TEE examination.And then they were divided into subgroups of normal and decreased LAA-FV groups.Results LAA-FV decreased sharply in the AF rhythm group[(29.47±10.91)cm/s vs(55.84±17.16)cm/s,P<0.01].In SR,LAA-FV was associated with CHA2DS2-VASc score(r=-0.248,P=0.003),and the CHA2DS2-VASc score differed between the normal and decreased LAA-FV groups[2(1-3)vs 4(2.5-4.3),P=0.007].GLALS was an independent predictor of LAA-FV in both AF rhythm and SR.Conclusions AF rhythm caused a sharp decrease in LAA-FV.In SR,the CHA2DS2-VASc score correlated negatively with LAA-FV.GLALS had independent predictive value for LAA-FV reduction.

关 键 词：心房颤动 左心耳 CHA2DS2-VASc评分 心房功能 应变 

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