实时三维超声心动图评价心房颤动患者射频消融术前后左心房功能及二尖瓣构型的变化  

Changes in Left Atrial Function and Mitral Valve Configuration After Radiofrequency Ablation in Patients with Atrial Fibrillation Using Real-Time Three-Dimensional Echocardiography

作　　者：吴治胜[1] 史琪[1] 武洋 唐琪[1] WU Zhisheng;SHI Qi;WU Yang;TANG Qi(Department of Echocardiography,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心脏超声诊断科,新疆乌鲁木齐830054

出　　处：《中国医学影像学杂志》2021年第2期142-147,共6页Chinese Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金联合基金(2016D01C268)。

摘　　要：目的探讨实时三维超声(RT-3DE)评价经导管射频消融术(RFCA)后未复发的非瓣膜病性心房颤动(NVAF)患者左心房容积参数与二尖瓣参数的变化,分析两者间的相关性和一致性。资料与方法对57例NVAF患者RFCA术前及术后3 d、1个月、3个月进行RT-3DE检查,测量左心房容积,应用分析软件获取收缩中期二尖瓣构型相关参数。分析手术前后左心房参数及二尖瓣参数的变化及其相关性,并进行重复性检验。结果术后3 d及1个月各指标变化与术前比较,差异均无统计学意义(P均>0.05);术后3个月与术前比较,左心房最大容积和左心房收缩前容积减小,左心房主动排空分数、左心房扩张指数及左心房整体射血分数均增加(P均<0.05)。术后3个月瓣环前后直径、瓣环前外侧至后内侧直径、瓣环周长、瓣环联合处直径、瓣环三维面积、瓣环二维面积、非平面角度、幕状区容积较术前及术后3 d内减小,瓣环高度增大(P均<0.05);术后3 d内幕状区高度、球形指数及瓣环最大位移、最大位移速率与术前比较,差异均无统计学意义(P均>0.05)。左心房容积参数与二尖瓣参数、左心房功能参数与二尖瓣参数、左心房功能与容积参数之间均呈显著相关(P均<0.05)。重复性检验显示,观察者间及观察者自身均有较好的一致性(P>0.05)。结论NVAF患者RFCA术后左心房开始缩小,左心房功能进一步恢复,二尖瓣“鞍型”结构进一步向正常结构转变,术后3个月时较术前有明显差异,且左心房与二尖瓣构型之间的变化在时间上具有一致性。Purpose To investigate the changes of left atrial volume parameters and mitral valve parameters in patients with unrelapse nonvalvular atrial fibrillation(NVAF)after radiofrequency catheter ablation(RFCA)by real-time three-dimensional echocardiography(RT-3DE),and analyze the correlation and concordance between them.Materials and Methods Fifty-seven patients with NVAF were examined with RT-3DE after operation of RFCA in three days,one month and three months.The parameters of left atrium volumes were measured,the mitral annulus and leaflet parameters were obtained.The changes of left atrial parameters and mitral valve parameters were studied,the correlation between left atrial parameters and mitral valve parameters were further verificated,and repeatability tests were performed.Results There was no significant difference in the changes of various indicators within three days and one month after operation compared with preoperation(P>0.05).Compared with pre-operation and three months after operation,maximum left atrial volume(LAVmax)and volume before left atrial active contraction(LAVpreA)decreased;LAactive,LAreservoir and left atrial ejection fraction(LAEF)increased(P<0.05).Compared with pre-operation and three months after operation,LAVmax and LAVpreA decreased;LAactive,LAreservoir and LAEF increased(P<0.05).In the comparison between three months after operation and pre-operation and three days after operation,anteriorposterior,AL-PM,annular circumference,commissural diameter,three-dimensional annular area,two-dimensional annular area,nonplanarity angle,tenting volume decreased,and AH increased(P<0.05).Compared with three months after operation,TH,SPI,ADmax and ADVmax were not statistically significant in pre-operation and three days after operation(P>0.05).There were significant correlations between left atrial volume and mitral valve parameters,left atrial function and mitral valve parameters and left atrial function and volume parameters(P<0.05).Repeatability test results showed a good agreement of each paramet

关 键 词：心房颤动 超声心动图 三维 导管消融术 心房功能 左 二尖瓣 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.5[医药卫生—诊断学]