非瓣膜性心房颤动患者及窦性心律者左心耳排空流速与左房功能参数的相关性研究  

Correlation between left atrial appendage emptying flow velocity and left atrial functional parameters in patients with non-valvular atrial fibrillation and sinus rhythm

作　　者：李永佳 何文[1] 张巍[1] 周怡希 兰亭玉 张萌 张惠琴[1] 杜丽娟[1] LI Yongjia;HE Wen;ZHANG Wei;ZHOU Yixi;LAN Tingyu;ZHANG Meng;ZHANG Huiqin;DU Lijuan(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京市100071

出　　处：《临床超声医学杂志》2023年第5期340-344,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81730050)。

摘　　要：目的应用经食管超声心动图(TEE)检测非瓣膜性心房颤动(以下简称房颤)患者及窦性心律者左心耳排空流速(LAAFV),探讨其与经胸超声心动图(TTE)所测左房功能参数的相关性。方法选取我院窦性心律者60例(窦性心律组)和非瓣膜性房颤患者30例(房颤组)。应用TTE获取左房收缩末期前后径(LADd_(前后))、左右径(LADd_(左右))、上下径(LADd_(上下)),以及左室舒张末期内径、左室射血分数(LVEF);斑点追踪技术获取左房储器期应变(LASr)、管道期应变(LAScd)、泵功能期应变(LASct),以及左室整体纵向应变(LVGLAS)、左房收缩末期最大容积(LAVmax);TEE检测LAAFV。比较两组上述各参数的差异;分析窦性心律组和房颤组LAAFV与TTE所测左房功能参数的相关性。结果房颤组LVEF、LVGLAS、LASr、LAScd、LASct、LAAFV均小于窦性心律组,LADd_(前后)、LADd_(左右)、LADd_(上下)、LAVmax均大于窦性心律组,两组比较差异均有统计学意义(均P<0.05)。相关性分析显示,窦性心律组和房颤组LAAFV与LASct均呈正相关(r=0.629、0.619,均P<0.05)。结论非瓣膜性房颤患者可出现左房形态及功能改变,但无论非瓣膜性房颤患者还是窦性心律者,LAAFV与左房泵功能均呈正相关,且相关程度一致。Objective To detect left atrial appendage emptying flow velocity(LAAFV)in patients with non-valvular atrial fibrillation and sinus rhythm by transesophageal echocardiography(TEE),and to investigate the correlation between LAAFV and with left atrial functional parameters measured by transthoracic echocardiography(TTE).Methods Sixty patients with sinus rhythm(sinus rhythm group)and 30 patients with non-valvular atrial fibrillation(atrial fibrillation group)in our hospital were selected.Left atrial anterior and posterior diameter(LADd_(a-p)),left and right diameter(LADd^(l-r)),upper and lower diameter(LADd_(u-l)),left ventricular end diastolic diameter,and left ventricular ejection fraction(LVEF)were obtained by TTE.Left atrial strain during reservoir phase(LASr),conduit phase(LAScd),contraction phase(LASct),left ventricular global longitudinal strain(LVGLAS)and left atrial maximum volume(LAVmax)were obtained by speckle tracking imaging technique.LAAFV was detected by TEE.The differences of above parameters between the two groups were compared.The correlation between LAAFV and left atrial functional parameters in the sinus rhythm group and non-valvular atrial fibrillation group were analyzed.Results The LVEF,LVGLAS,LASr,LAScd,LASct and LAAFV in the atrial fibrillation group were all lower than those in the sinus rhythm group,and the LADd_(a-p),LADd_(l-r),LADd_(u-l) and LAVmax were all higher than those in the sinus rhythm group.The differences between the two groups were statistically significant(all P<0.05).Correlation analysis showed that there was a significant positive correlation between LAAFV and LASct in both sinus rhythm group and non-valvular atrial ibrillation group(r=0.629,0.619,both P<0.05).Conclusion Patients with non-valvular atrial fibrillation may have altered left atrial morphology and function,but LAAFV is positively correlated with left atrial contraction function in both non-valvular atrial fibrillation and sinus rhythm patients,and the degree of correlation is consistent.

关 键 词：超声心动描记术 斑点追踪 左心耳 排空流速 心房功能 

分 类 号：R540.45[医药卫生—心血管疾病] R541.7[医药卫生—内科学]