舒张功能指标对非瓣膜性心房颤动患者左心耳血栓形成的影响  

Effect of diastolic function parameters on thrombus formation of left atrial appendage in patients with non valvular atrial fibrillation

作　　者：郭耀磊[1] 张倩倩[1] 施新龙 GUO Yao-lei;ZHANG Qian-qian;SHI Xin-long(Department of Cardiology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2021年第1期44-48,共5页Journal of Harbin Medical University

摘　　要：目的探讨舒张功能指标对非瓣膜性心房颤动患者左心耳血栓(left atrial appendage thrombus,LAAT)形成的影响。方法收集我院2017年1月~2018年10月行经食道超声心动图检查的非瓣膜性心房颤动患者152例,根据是否有LAAT分为血栓组和对照组,比较舒张功能指标在两组间的差异并分析对LAAT形成的影响。结果血栓组左房内径、左房容积指数(LAVI)及平均二尖瓣舒张早期血流速度与二尖瓣环舒张早期速度的比值(E/e′)显著大于对照组,平均二尖瓣环舒张早期速度(e′)、左心耳排空速度(LAAev)及左室射血分数低于对照组(P<0.05),两组间三尖瓣峰值反流速度无显著差异。相关分析显示:(1)LAVI及平均E/e′与LAA-ev呈负相关(r值分别为-0.444,-0.608,P均<0.05);(2)平均E/e′、LAVI与LAAT呈正相关(r值分别为0.362,0.364,P均<0.05),平均e′与LAAT呈负相关(r值=-0.196,P<0.05)。多因素Logistic回归分析显示,平均E/e′及LAVI是LAAT形成的独立影响因素。结论舒张功能指标平均E/e′及LAVI是LAAT形成的独立影响因素,或许有助于非瓣膜心房颤动患者LAAT的危险分层。Objective To explore the effect of diastolic function indices on left atrial appen-dage thrombus(LAAT)in patients with nonvalvular atrial fibrillation.Methods A total of 152 patients with nonvalvular atrial fibrillation,undergoing transesophageal echocardiography from January 2017 to October 2018 in our hospital were collected,who were divided into thrombus group and control group according to whether there was LAAT or not.Differences of diastolic function parameters between the two groups were compared and the influence on LAAT formation was analyzed.Results Left atrial diameter,left atrial volume index(LAVI)and the average ratio of early diastolic velocity of mitral valve to early diastolic velocity of mitral annulus(E/e′)in thrombus group were significantly higher than those in control group.The average early diastolic velocityof mitral annulus(e′),left atrial appendage emptying velocity(LAAev)and left ventricular ejection fraction of thrombus group were lower than those of control group(P<0.05).There was no significant difference in peak tricuspid regurgitation velocity between the two groups.Correlation analysis showed that:(1)LAVI and the average E/e′were negatively correlated with LAAev(r values were-0.444 and-0.608,respectively;all P<0.05).(2)The average E/e′,LAVI and LAAT were positively correlated(r values were 0.362 and 0.364,respectively;all P<0.05),and theaverage e′and LAAT were negatively correlated(r=-0.196,P<0.05).Multivariate logistic regression analysis that showed that the average E/e′and LAVI were independent factors of LAAT formation.Conclusion Diastolic function indices the average E/e′and LAVI are independently associated with LAAT,which might contribute to risk stratification of LAAT in nonvalvular atrial fibrillation patients.

关 键 词：舒张功能 心房颤动 左心耳血栓 

分 类 号：R541.75[医药卫生—心血管疾病]