超声评估不同类型房颤心脏重构和心外膜脂肪差异与心衰相关性分析  

Ultrasound assessment of cardiac remodeling and epicardial adipose tissue differences in different types of atrial fibril⁃lation in relation to heart failure

作　　者：邱雨 高振森[2] 郭利平[2] 李丹丹[2] 张文文[2] 罗袖云 缪伟[2] QIU Yu;GAO Zhensen;GUO Liping;LI Dandan;ZHANG Wenwen;LUO Xiuyun;MIAO Wei(School of Medical Imaging,Shandong Second Medical University,Weifang 261053,China;Department of Ultrasound Center,Weifang People’s Hospital,Weifang 261041,China)

机构地区：[1]山东第二医科大学医学影像学院,山东潍坊261053 [2]山东省潍坊市人民医院超声医学科,山东潍坊261041

出　　处：《医学影像学杂志》2024年第11期48-52,共5页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:2019WS252);山东省潍坊市科技发展计划(软科学)项目(编号:2022RKX021)。

摘　　要：目的应用超声评估不同类型房颤(AF)患者的心脏重构及心外膜脂肪(EAT)参数变化情况,探讨其与心衰发生的相关性和预测价值。方法选取接受心脏超声检查的108例患者资料,分为窦性心律正常(对照组)34例、阵发性AF组39例与永久性AF组35例,分析临床资料与实验室资料,包括体重指数(BMI)、体表面积(BSA)、N末端脑钠肽(NT-ProBNP)等,采用超声心动图测量心脏相关指标,包括心外膜脂肪量(EAT)、左心房面积(LAA)、左心房容积指数(LAVI)、右心房容积(RAV)、双心房面积比(LAA/RAA)、左心房球形度(LASI)等。结果阵发性AF组与永久性AF组NT-ProBNP、LAA、LAVI均高于对照组,差异有统计学意义(P均<0.05),永久性AF组RAV、LASI高于阵发性AF组,差异有统计学意义(P均<0.05),阵发性AF组EAT、LAA/RAA高于永久性AF组,差异有统计学意义(P均<0.05)。结论不同类型的AF患者心脏重构有差异,阵发性AF左心房可以扩大或正常、EAT增多。永久性AF患者左、右心房可以同时扩大,EAT减少。不同类型AF心脏重构与心衰程度相关。Objective The changes of cardiac remodeling and epicardial adipose tissue(EAT)in patients with different types of atrial fibrillation(AF)were evaluated by ultrasound,and the correlation and predictive value of these parameters with the occurrence of heart failure were discussed.Methods A total of 108 patients who received cardiac ultrasound in our hospital were divided into normal sinus rhythm control group(34 cases),paroxysmal atrial fibrillation(PaAF)group(39 cases),and permanent atrial fibrillation(PeAF)group(35 cases).Clinical and laboratory data were collected.Body mass index(BMI),body surface area(BSA),N-terminal brain natriuretic peptide(NT-ProBNP)and other heart-related indicators were measured by ultrasound in terms of epicardial adipose tissue(EAT),left atrial area(LAA),left atrial volume index(LAVI),right atrial volume(RAV),double atrial area ratio(LAA/RAA),left atrial sphericity index(LASI),etc.Results NT-ProBNP,LAA and LAVI in paroxysmal AF group and permanent AF group were higher than those in normal control group(P<0.05).RAV and LASI in permanent AF group were higher than those in paroxysmal AF group(P<0.05).EAT,LAA/RAA in paroxysmal AF group were higher than those in permanent AF group(P<0.05).Conclusion There are differences in cardiac remodeling in patients with different types of atrial fibrillation.The left atrium(LA)may be enlarged or normal with EAT increase in PaAF.PeAF can enlarge the left atrium and right atrium(RA)simultaneously and reduce EAT.Cardiac remodeling in different types of atrial fibrillation is correlated with the degree of heart failure.

关 键 词：房颤 超声检查 分型 心脏重构 心外膜脂肪 

分 类 号：R574.1[医药卫生—消化系统] R445.1[医药卫生—内科学]