| 摘要: |
| 摘 要 目的 应用二维斑点追踪成像技术评价风湿性心脏病合并心房颤动(房颤)患者的左心耳功能，探讨左心耳应变率与心肌的纤维化程度的相关性。方法 回顾性分析2019年1月至2020年12月就诊于宜昌市中心人民医院的36例接受瓣膜置换术联合改良射频迷宫术的风湿性心脏病合并房颤患者，入组患者术前均接受经食道超声心动图检查，测得左心耳应变率参数，收集左心耳标本，定量左心耳纤维化程度。随访6个月后根据是否复发房颤分为复发组和非复发组。结果 随访6个月后，8例复发房性心律失常。与非复发组相比，复发组收缩期左心耳应变率及左心耳基底段应变率、左心耳顶段应变率均低于非复发组；复发组左心耳纤维化程度较非复发组更严重，差异均有统计学意义（P<0.05）。相关性分析显示收缩期左心耳应变率与左心耳整体纤维化程度呈负相关（r=-0.766，P<0.01）；左心耳基底段、中间段、顶段的应变率与对应节段的纤维化程度呈负相关(r=-0.752,-0.547,-0.589,均P<0.01)。结论 消融术后复发者左心耳纤维化程度更重。风湿性心脏病合并房颤患者的左心耳应变率与纤维化程度呈负相关，分段研究中左心耳基底段与纤维化程度相关性最显著。研究结果表明二维斑点追踪成像技术在评估心肌纤维化程度方面具有一定的价值。 |
| 关键词: 左心耳应变率 心肌纤维化 心房颤动 二维斑点追踪成像技术 |
| DOI： |
| 投稿时间：2021-07-14修订日期：2021-09-06 |
| 基金项目: |
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| Correlation analysis between left Atrial and appendage strain rate and myocardial fibrosis in rheumatic heart disease patients with atrial fibrillation |
| sun heng,zhou chang,zhou jun,zhang songlin |
| () |
| Abstract: |
| ABSTRACT Objective The purpose of this research is to analyze the association between left atrial appendage (LAA) mechanical parameters assessed by two-dimensional speckle tracking technology(2D-STI) and the degree of myocardial fibrosis in patients with rheumatic heart disease (RHD)and atrial fibrillation (AF). Methods The study included 36 patients with RHD and AF who underwent transesophageal echocardiography (TEE). They were scheduled to undergo valve replacement combined with modified radiofrequency maze surgery in Yichang Central people's Hospital from January 2019 to December 2020. The LAA strain rate and the degree of LAA fibrosis of all patients were evaluated. The patients were divided into two group according to the recurrence of AF after 6 months. Results After a follow-up of six months, eight patients had recurrent atrial fibrillation. We found that compared with the non-recurrent group, the LAALSRs、LAALSRs1 and LAALSRs3 in the recurrent group were significantly lower than those in the non-recurrent group (P < 0.05). The degree of fibrosis in the recurrent group was more serious than that in the non-recurrent group (P < 0.05). Correlation analysis showed that the systolic strain rate of left atrial appendage was negatively correlated with the degree of overall fibrosis of left atrial appendage (r = 0.766, P < 0.0l), and the strain rates of basal, middle and the tip of left atrial appendage were negatively correlated with the degree of fibrosis of corresponding segments (r =-0.752, -0.547, -0.589, P < 0.01). Conclusions The degree of left atrial appendage fibrosis in patients with atrial fibrillation recurrence after ablation is more severe. LAA strain rate is negatively correlated with the degree of myocardial fibrosis in patients with RHD and AF and the r values of the basal segment of the left atrial appendage is higher. The 2D-STI has a certain value in evaluating the degree of myocardial fibrosis. |
| Key words: Key words：Left Atrial appendage strain rate Myocardial fibrosis Atrial Fibrillation Two-dimensional speckle tracking technology |
