超声评估心房颤动患者右室游离壁周围心外膜脂肪厚度与左房时相功能的相关性研究  

Echocardiography evaluation of the association between epicardial adipose tissue thickness around the right ventricular free wall and left atrial phase function in patients with atrial fibrillation

作　　者：杨优 刘表虎[1] 王德国[1] 纪文艳 丁静 陶善强 练菲菲 YANG You;LIU Biao-hu;WANG De-guo;JI Wen-yan;DING Jing;TAO Shan-qiang;LIAN Fei-fei(Yijishan Hospital of Wannan Medical College,Wuhu Anhui 241001,China)

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241001

出　　处：《中国临床医学影像杂志》2023年第5期344-348,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金资助项目(项目编号81670301);安徽省高等学校省级质量工程项目(项目编号2020xskt525)。

摘　　要：目的:通过超声心动图技术研究心房颤动患者右室游离壁周围心外膜脂肪(EAT)厚度与左房时相功能的相关性。方法:选择非瓣膜性房颤患者100例,其中阵发性房颤及持续性房颤患者各50例。另选取窦性心律的非房颤患者50例作为对照组。使用经胸超声心动图(TTE)测量收缩末期右室游离壁前方的EAT厚度,同时使用实时三维超声心动图(RT-3DE)和二维斑点追踪显像技术(2D-STI)获取左房时相功能参数,包括左房总射血分数(LATEF)、左房主动射血分数(LAAEF)、左房被动射血分数(LAPEF)、左房储器应变(LASr)、左房收缩应变(LASct)及左房管道应变(LAScd)。比较各组间EAT厚度及左房时相功能参数,并且分析EAT厚度与左房时相功能参数的相关性。结果:相比对照组,阵发性房颤组及持续性房颤组患者EAT厚度及左房直径依次增大,但左房时相功能参数依次降低(P<0.05)。房颤患者EAT厚度与左房直径呈显著正相关,与左房时相功能参数呈显著负相关(P<0.05)。结论:TTE测量的右室游离壁前方EAT厚度与房颤患者左房时相功能的降低显著相关,能够有效反映左房功能变化趋势,从而为临床诊疗及左房重构的早期干预提供一定的参考。Objective:To explore the relationship between epicardial adipose tissue(EAT)thickness around the right ven-tricular free wall and left atrial phase function in patient with atrial fibrillation.Methods:100 non-valvular atrial fibrillation patients were enrolled,including 50 patients with paroxysmal atrial fibrillation and 50 patients with persistent atrial fibrillation.Another 50 patients without atrial fibrillation in sinus rhythm were selected as the control group.EAT thickness in front of the right ventricular free wall at end-systole was measured using transthoracic echocardiography(TTE),while left atrial phase function parameters were measured by real-time three-dimensional echocardiography(RT-3DE)and two-dimensional speckle tacking imaging(2D-STI),including left atrial total emptying fraction(LATEF),left atrial active emptying fraction(LAAEF),left atrial passive emptying fraction(LAPEF),left atrial reservoir strain(LASr),left atrial contraction strain(LASct)and left atrial con-duit strain(LAScd).The EAT thickness and left atrial phase function parameters were compared among the groups,and the relationship was analyzed between them.Results:Compared with the control group,the EAT thickness and left atrial diameter(LAD)of patients in paroxysmal atrial fibrillation and persistent atrial fibrillation groups increased in turn,but the left atrial phase function parameters decreased in turn(P<0.05).And EAT thickness in patients with atrial fibrillation was significantly positively correlated with left atrial diameter,and negatively correlated with left atrial phase function parameters(P<0.05).Con-clusions:The EAT thickness measured by TTE is significantly correlated with left atrial phase function in patients with atrial fibrillation,which can effectively reflect the trend of left atrial function changes,thus providing some reference for clinical practice and early intervention of left atrial remodeling.

关 键 词：心房颤动 心包 超声心动描记术 

分 类 号：R541.75[医药卫生—心血管疾病] R540.45[医药卫生—内科学]