心房颤动行导管消融术后左心室实时三维超声心动图特征分析  

Characteristics of real-time three-dimensional echocardiography of the left ventricle after catheter ablation for atrial fibrillation

作　　者：陈怡 谢晋 Chen Yi;Xie Jin(Department of Ultrasound,Traditional Chinese Medical Hospital of Zhuji,Zhuji 311800,Zhejiang Province,China;Department of Ultrasound,Shengzhou People's Hospital,Shengzhou 312400,Zhejiang Province,China)

机构地区：[1]诸暨市中医医院超声科,诸暨311800 [2]嵊州市人民医院超声科,嵊州312400

出　　处：《中国基层医药》2025年第2期161-165,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省绍兴市科技计划(医药卫生类)(2018C30163)。

摘　　要：目的观察导管消融术不同预后心房颤动(AF)患者左心室实时三维超声心动图(RT-3DE)指标的变化, 为RT-3DE评估阵发性心房颤动(PAF)与持续性心房颤(PEAF)病情及预后提供依据。方法采用病例对照研究, 选取诸暨市中医医院2018年6月至2022年12月诊治并接受导管消融术治疗的PAF患者70例和PEAF患者70例为研究对象, AF患者均于导管消融术前和术后3个月行RT-3DE检查。比较不同类型AF及不同预后患者导管消融术前后左心室RT-3DE指标的差异。结果 PAF患者术前左心室舒张末期容积(LVEDV)[(31.68±2.89)mL]显著低于PEAF患者[(35.59±3.26)mL], 而左心室射血分数(LVEF)[(64.41±5.87)%]显著高于PEAF患者[(58.62±5.63)%], 两者比较, 差异均有统计学意义(t=-6.33、5.93, 均P < 0.001)。PAF与PEAF患者导管消融术后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、LVEDV、左心室收缩末期容积(LVESV)、二尖瓣舒张早期峰值流速(E)、二尖瓣舒张早期峰值流速与二尖瓣环舒张早期运动峰值速度的比值(E/e′)均较术前显著减小, 而左心室射血分数(LVEF)和二尖瓣环舒张早期运动峰值速度(e′)均较术前显著增加(t=-5.12、-5.47、-4.63、-4.25、-17.44、-18.06、-13.57、-14.66、4.27、7.52、-6.86、-4.96、6.35、5.81、-9.85、-8.78, 均P < 0.001)。PAF和PEAF导管消融术后复发患者术前e′检测数值均显著高于未复发患者, 而E/e′检测数值均显著低于未复发患者(t=10.53、9.84、-15.47、-15.32, 均P < 0.001)。结论不同类型AF经导管消融术后复发与非复发患者e′、E/e′等RT-3DE指标均有差异, 通过RT-3DE结合组织多普勒技术监测左心室结构和功能变化对评估PAF与PEAF病情差异及导管消融术预后有潜在价值。Objective:To observe the changes in left ventricular real-time three-dimensional echocardiography(RT-3DE)parameters in patients with atrial fibrillation(AF)who have different prognoses after catheter ablation,providing evidence for using RT-3DE to assess the condition and prognosis of paroxysmal atrial fibrillation(PAF)and persistent atrial fibrillation(PEAF).Methods:This case-control study included 70 patients with PAF and 70 patients with PEAF,all of whom were diagnosed and treated with catheter ablation at Traditional Chinese Medical Hospital of Zhuji from June 2018 to December 2022.All AF patients underwent RT-3DE examinations both before and 3 months after catheter ablation.We compared the changes in left ventricular RT-3DE parameters before and after catheter ablation among different types of AF and patients with varying prognoses.Results:Before catheter ablation,patients with PAF had a left ventricular end-diastolic volume of(31.68±2.89)mL,which was significantly lower than that in patients with PEAF[(35.59±3.26)mL,t=-6.33,P<0.001].Additionally,the left ventricular ejection fraction in PAF patients was(64.41±5.87)%,which was significantly higher than that in PEAF patients[(58.62±5.63)%,t=5.93,P<0.001].After catheter ablation,both PAF and PEAF patients showed significant reductions in left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume,early diastolic peak flow velocity of the mitral valve(E),and the ratio of E to the peak velocity of early mitral annular motion(e′)compared with corresponding preoperative values(t=-5.12,-5.47,-4.63,-4.25,-17.44,-18.06,-13.57,-14.66,4.27,7.52,-6.86,-4.96,6.35,5.81,all P<0.001).Conversely,left ventricular ejection fraction and the e′significantly increased compared with corresponding preoperative values(t=-9.85,-8.78,both P<0.001).In patients who experienced recurrence of AF after catheter ablation,the preoperative e′values were significantly higher compared with th

关 键 词：超声心动描记术 压力 超声检查 多普勒 彩色 心房颤动 导管消融术 心室功能 左 预后 复发 

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