左房功能对孤立性房颤患者左心耳血栓形成的预测价值  

Predictive value of left atrial function for left atrial appendage thrombosis in patients with isolated atrial fibrillation

作　　者：邢小飞 曾理[2] 李蕾[1] 苏倩 马苗[1] 陈丽[1] 熊璐 秦梦斌 XING Xiao-fei;ZENG Li;LI Lei;SU Qian;MA Miao;CHEN Li;XIONG Lu;QIN Meng-bin(Department of Ultrasound,Tianyou Hospital,Wuhan University of Science and Technology,Wuhan 430064,Hubei,China;Department of Ultrasound,Tianmen First People’s Hospital,Tianmen 431700,Hubei,China)

机构地区：[1]武汉科技大学附属天佑医院超声科,湖北武汉430064 [2]天门市第一人民医院超声科,湖北天门431700

出　　处：《心脏杂志》2024年第6期656-659,共4页Chinese Heart Journal

摘　　要：目的探讨左房功能对孤立性房颤患者左心耳血栓形成的预测价值。方法选取于武汉科技大学附属天佑医院与湖北省天门市第一人民医院140例孤立性房颤且左室射血分数(LVEF)≥50%的患者,据左心耳内有无血栓将患者分为无血栓组和血栓组,对两组患者均行超声检查,应用二维斑点追踪技术测量各切面左房应变(LA-LS),左房整体应变(GLS)以及各节段应变达峰时间标准差(LA-TPSD),详细记录两组患者的基线资料及各项超声参数,比较两组间各项指标差别。结果血栓组阵发性房颤的比例明显低于无血栓组(P<0.01);与无血栓组比较,血栓组的LA-T(P<0.05)、LAEDV(P<0.01)、LAESV(P<0.01)明显大于无血栓组,LAEF(P<0.01)及LAA-v(P<0.01)小于无血栓组。斑点追踪参数对比,四腔、三腔及两腔心切面的左房纵向应变及左房整体应变在血栓组小于无血栓组,左房各节段纵向应变达峰时间标准差在血栓组大于无血栓组,两组间各项参数均存在统计学差异(均P<0.05)。结论孤立性房颤患者左心耳血栓的形成与左房结构功能、收缩协调性均有相关性,左房相关参数对血栓的形成有一定无创性预测价值。AIM To investigate the predictive value of left atrial function for left atrial appendage thrombosis in patients with isolated atrial fibrillation(AF).METHODS One hundred and forty patients who were definitely diagnosed as isolated AF and left ventricular ejection fraction(LVEF)≥50%were selected as disease group.The disease group were further divided into non-thrombus group and thrombus group,and 60 healthy subjects served as control group.Ultrasound examination was performed in all 3 groups.The left atrial longitudinal strain(LA-LS),the global strain(GLS)of LA and the standard deviation for the time to peak of LA(LA-TPSD)in each section were measured by two-dimensional speckle tracking imaging(2D-STI)and the data were compared between the three groups.RESULTS The proportion of paroxysmal atrial fibrillation in the thrombotic group was significantly lower than that in the non thrombotic group(P<0.01);Compared with the non thrombotic group,the LA-T(P<0.05),LAEDV(P<0.01),and LAESV(P<0.01)in the thrombotic group were significantly higher than those in the non thrombotic group,while LAEF(P<0.01)and LAA-v(P<0.01)were lower than those in the non thrombotic group.Comparison of spot tracking parameters showed that the longitudinal strain and overall strain of the left atrium in the four chamber,three chamber,and two chamber heart sections were smaller in the thrombus group than in the non thrombus group.The standard deviation of the peak time of longitudinal strain in each segment of the left atrium was greater in the thrombus group than in the non thrombus group.There were statistical differences in all parameters between the two groups(all P<0.05).CONCLUSION The left atrial appendage thrombosis in patients with isolated AF is closely related to the LA structure,function and systolic coordination.The left atrial related parameters have certain noninvasive predictive value for the formation of thrombosis.

关 键 词：左房功能 孤立性房颤 左心耳血栓 

分 类 号：R541.75[医药卫生—心血管疾病]