二尖瓣环位移自动追踪技术评价阵发性心房颤动患者左房收缩功能  

Evaluation of left atrial systolic function in patients with paroxysmal atrial fibrillation by tracking of mitral annular displacement technology

作　　者：马秀玲 郭泰[2] 芦芳[1] MA Xiuling;GUO Tai;LU Fang(Department of UItrasound,the Second Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第二医院超声科,太原市030000 [2]山西医科大学第三医院骨科

出　　处：《临床超声医学杂志》2021年第5期360-364,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用二尖瓣环位移自动追踪(TMAD)技术评价阵发性心房颤动(以下简称房颤)患者左房收缩功能。方法选取30例阵发性房颤患者(病例组)和30例正常对照组,应用二维斑点追踪超声心动图(2D-STE)技术获取左室收缩期、舒张早期、舒张晚期的左房平均峰值应变率(mSRs、mSRe、mSRa),以及经标化的左房最大容积指数(LAVimax)、最小容积指数(LAVimin)、收缩前容积指数(LAVip),并计算左房总排空分数(LATEF)、被动排空分数(LAPEF)、主动排空分数(LAAEF);同时TMAD技术获取时间-位移曲线,测量左室收缩期二尖瓣环位移(TMAD-D)、左房收缩期二尖瓣环位移(TMAD-S);比较两组上述各参数差异。绘制受试者工作特征(ROC)曲线分析应变率及TMAD参数对阵发性房颤患者的诊断效能;并对TMAD参数进行重复性检验。比较两种技术测量用时。结果病例组LAVimax、LAVimin及LAVip均较对照组增大,LATEF、LAPEF、LAAEF、mSRs、mSRe、mSRa、TMAD-D、TMAD-S均较对照组减小,差异均有统计学意义(均P<0.05)。TMAD-D、TMAD-S、mSRs、mSRa预测阵发性房颤的ROC曲线下面积分别为0.867、0.808、0.944、0.850。TMAD-D和TMAD-S观察者内组内相关系数分别为0.964、0.888,观察者间组内相关系数分别为0.918、0.860。TMAD测量用时较2D-STE明显缩短(P<0.05)。结论 TMAD可评估阵发性房颤患者左房收缩功能,与2D-STE诊断效能相当,但TMAD较2D-STE检测时间更短。ObjectiveTo evaluate the left atrial systolic function in patients with paroxysmal atrial fibrillation(PAF)by tracking of mitral annular displacement technology(TMAD).MethodsThirty patients with PAF(case group)and 30 normal controls(control group)were selected.The mean value of the peak strain rate of left ventricular systolic,early and late diastolic of left atrium(mSRs,mSRe,mSRa),standardized left atrial maximal volume index(LAVimax), minimal volume index(LAVimin)and pre systolic volume index(LAVip)were obtained by two-dimensional speckle tracking echocardiography(2 D-STE),and left atrial total emptying fraction(LATEF), passive emptying fraction(LAPEF) and active emptying fraction(LAAEF) were calculated. Meanwhile,the time-displacement curve was obtained by TMAD,the left ventricular systolic mitral annular displacement(TMAD-D)and left atrial systolic mitral annular displacement(TMAD-S)were measured.And the differences of above parameters were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the values of strain rate and TMAD parameters in detecting PAF.And the repeatability test of TMAD parameters was conducted.The measurement time of TMAD and 2 D-STE was recorded.Results LAVip in case group were higher,and LATEF,LAPEF,LAAEF,mSRs,mSRe,mSRa,TMAD-D,TMAD-S in case group were lower,the differences were statistically significant(all P<0.05).The area under the ROC curve of TMAD-D,TMAD-S,mSRs and mSRa in predicting PAF were about 0.867,0.808,0.944 and 0.850,respectively.The intra-observer correlation coefficients of TMAD-D and TMAD-S mean were 0.964 and 0.888,and the inter-observer correlation coefficients were 0.918 and 0.860,respectively.The measurement time of TMAD was significantly shorter than that of 2 D-STE(P<0.05).ConclusionTMAD can detect the changes of left atrial systolic function in patients with PAF,and the detection time of TMAD is shorter than that of2 D-STE.

关 键 词：二尖瓣环位移自动追踪技术 斑点追踪 二维 阵发性房颤 收缩功能 心房 左 

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