二维斑点追踪成像技术评价非瓣膜性心房颤动患者左心耳功能的应用价值  

Application Value of Two-Dimensional Speckle Tracking Imaging Technology in Evaluating Left Atrial Appendage Function in Patients with Nonvalvular Atrial Fibrillation

作　　者：薛娜[1] 刘昕[1] 穆维娜[1] 吕冰 XUE Na;LIU Xin;MU Weina;LV Bing(Department of Ultrasound,Baoding NO.1 Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院超声一科,河北保定071000

出　　处：《中国医疗设备》2021年第9期74-78,共5页China Medical Devices

摘　　要：目的应用二维斑点追踪成像技术(Two-Dimension ultrasonic Speckle Tracking Imaging,2D-STI)评价非瓣膜性心房颤动(Non-Valvular Atrial Fibrillation,NVAF)患者的左心耳(Left Atrial Appendage,LAA)功能的应用价值,为预测LAA血栓的形成提供参考。方法收集房颤患者60例,其中LAA无血栓组31例,有血栓组29例,另选正常对照组30例。应用经胸超声心动图(Transthoracic Echocardiography,TTE)测量左房前后径(Left Atrial Diameter,LAD),应用经食管超声心动图(Transesophageal Echocardiography,TEE)采集LAA图像,分别测量左心耳开口径(Left Atrial Appendage Diameter,LAA-D)、左心耳长度(Left Atrial Appendage Length,LAA-L)、左心耳峰值血流排空速度(Left Atrial Appendage Peak blood flow Emptying Velocity,LAA-PEV)、左心耳排空分数(Left Atrium Appendage Emptying Fraction,LAA-EF),应用2D-STI得出左心耳整体长轴应变(Left Atrial Appendage Global Longitudinal Strain,LAA-GLS),分析各指标对评价LAA功能的价值。结果LAA-D、LAA-L组间差异无统计学意义(P>0.05),无血栓组LAA-GLS、LAA-EF均较对照组减低(P<0.05),有血栓组LAA-PEV、LAA-GLS、LAA-EF均较对照组减低、LAD较对照组升高(P<0.05),有血栓组LAA-PEV、LAA-GLS较无血栓组减低(P<0.05)。LAA-PEV、LAA-GLS、LAA-EF与CHA2DS2-VASc评分有相关性(P<0.05),r分别为-0.664、-0.826、-0.723。ROC曲线显示LAA-GLS定量评价LAA功能的灵敏度(0.833)和特异度(0.850)均最高;房颤患者以10.68为截断点时,预测LAA血栓的灵敏度和特异度分别为0.806、0.690。结论经食管超声心动图2D-STI可定量评价LAA功能的改变,对预测LAA血栓形成有重要意义,为临床用药和治疗提供影像学依据。Objective To evaluate the function of left atrial appendage(LAA)in patients with non-valvular atrial fibrillation(NVAF)by applying Two-Dimension ultrasonic Speckle Tracking Imaging(2D-STI),and provide a reference for predicting the formation of LAA thrombus.Methods A total of 60 patients with atrial fibrillation were collected,including 31 patients in the left atrial appendage without thrombosis group,29 patients in the LAA group with thrombosis,and 30 patients in the normal control group.The left atrial diameter(LAD)was measured using transthoracic echocardiography(TTE).The LAA images were collected on transesophageal echocardiography(TEE),and the left atrial appendage diameter(LAA-D)was measured respectively.left atrial appendage length(LAA-L),left atrial appendage peak blood flow emptying velocity(LAA-PEV),left atrium appendage emptying fraction(LAA-EF),the left atrial appendage global longitudinal strain(LAA-GLS)was obtained using 2D STI,and the value of each indicator in the evaluation of LAA function was analyzed.Results There were no significant differences between LAA-D and LAA-L groups(P>0.05).LAA-GLS and LAA-EF in the no thrombus-free group were lower than those in the control group(P<0.05).LAA-PEV,LAA-GLS and LAA-EF in the thrombosis group were lower than those in the control group,and LAD was higher than those in the control group(P<0.05).LAA-PEV and LAA-GLS in the thrombus group were lower than those in the non-thrombosis group(P<0.05).LAA-PEV,LAA-GLS and LAA-EF were correlated with CHA2DS2-VASC score(P<0.05),and r was-0.664,-0.826,-0.723,respectively.ROC curve showed that LAA-GLS had the highest sensitivity(0.833)and specificity(0.850)for quantitative evaluation of LAA function.When the cut-off point was 10.68 in patients with atrial fibrillation,the sensitivity and specificity of predicting LAA thrombus were 0.806 and 0.690,respectively.Conclusion Transesophageal echocardiography 2D-STI can quantitatively evaluate changes in left atrial appendage function,which is of great significance in predictin

关 键 词：超声心动图 心房颤动 左心耳 斑点追踪成像 

分 类 号：R540.45[医药卫生—心血管疾病]