| 摘要: |
| 目的 探讨斑点追踪技术及右心声学造影对阵发性房颤复发的预测作用。方法 对2019年1月至2019年12月经我院心内科诊断为阵发性房颤（PAF）患者33例进行前瞻性研究，分别在房颤发作时及未发作时行超声心动图及右心声学造影增强检查，测量造影前后右室舒张末面积、右室收缩末面积，计算右室面积变化分数（FAC）；观察右室心内膜边界变化。脱机分析房颤发作及未发作时三尖瓣瓣环平面收缩期位移（TAPSE）、左室整体纵向应变（LVGLS）及右室整体纵向应变（RVGLS）；以造影后及房颤未发作时的数据作为基线值；6个月后根据房颤是否复发分为两组，再次测量上述参数，比较各组数据之间差异。结果 图像改善值≥6者造影前后FAC差异有统计学意义。房颤未发作时LVGLS、RVGLS较发作时下降（P<0.05）。6个月后房颤复发组RVGLS较本组基线值下降（P<0.05），且低于未复发组（P<0.05）。复发组RVGLS基线值低于未复发组（P<0.05），各组之间LVGLS差异无统计学意义。RVGLS <17.98时，预测PAF复发敏感性71.1%，特异性72.9%。结论 RVGLS可敏感反映右室功能变化，对PAF复发具有一定的预测价值；LVGLS对PAF复发无预测价值。右心声学造影增强检查可明显改善右室图像清晰度，对预测PAF的复发无明显作用。 |
| 关键词: 超声心动图 心房颤动 右心室 造影 |
| DOI： |
| 投稿时间：2020-09-07修订日期：2020-10-12 |
| 基金项目: |
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| Evaluating the Prediction of recurrent paroxysmal atrial fibrillation by speckle tracking imaging and contrast-enhanced echocardiography |
| Qi Dong,Li Huizhong |
| (Bengbu Medical College;Department of Ultrasound Diagnosis, The 900th Hospital of the Joint Logistic Team, Bengbu Medical College Teaching Hospital) |
| Abstract: |
| Objective To investigate speckle tracking imaging and right heart contrast-enhanced echocadiography in predicting the recurrence of paroxysmal atrial fibrillation（PAF）.Methods A total of 33 patients who were diagnosed with PAF in the cardiovascular medicine department from January 2019 to December 2019 were prospective study. 2D echocardiography and right heart contrast-enhanced echocardiography were performed at AF paroxysm and sinus rhythm respectively. Right ventricular end diastolic area, right ventricular end systolic area, right ventricular fractional area change (FAC) was measured with and without contrast-enhanced echocardiography respectively. The changes of the endocardial boundary of the right ventricle were observed during contrast-enhanced echocardiography. Tricuspid annular plane systolic excursion (TAPSE), left ventricular global longitudinal strain (LVGLS)，right ventricular global longitudinal strain (RVGLS) were calculated at atrial fibrillation paroxysm and sinus rhythm respectively. The values which were measured at sinus rhythm and with contrast-enhanced echocardiography were taken as the baseline value. After 6 months, the two groups were divided according to whether atrial fibrillation recurred or not. The parameters were evaluated again. Compared to the differences between these groups. Results There was statistical difference between patients with and without contrast-enhanced echocardiography of FAC, when the value of improvement was≥6. LVGLS, RVGLS decreased in AF paroxysm than those in sinus rhythm (P<0.05). After 6 months, RVGLS in the recurrent group decreased from the baseline value of the same group (P<0.05), and was lower than that in the non-recurrent group(P<0.05). The baseline value of RVGLS in the recurrence group was lower than that in the non-recurrence group (P<0.05). There was no significant difference in the value of LVGLS between these groups. When RVGLS<17.98, sensitivity and specificity to predict AF recurrence was 71.1% and 72.9%. Conclusions RVGLS can be sensitive to changes in right ventricular function, which could help to predict PAF recurrence. However, LVGLS has no predictive value for PAF recurrence. Contrast enhancement of the right heart can significantly improve the clarity of right ventricular images, but has no significant effect on the prediction of PAF recurrence. |
| Key words: Echocardiography Atrial fibrillation Right ventricles Contrast media |
