| 摘要: |
| 目的 对比分析非瓣膜性房颤及窦性心律人群经食管超声心动图(TEE)左心耳排空流速(LAAFV)与经胸超声心动图(TTE)左心房功能参数相关性及其异同,为非介入性超声技术评估左心耳血流状态探寻有价值的参数指标。方法 选取2021年11月至2022年11月于我院因房颤或头晕头痛等就诊并同期完成TTE及TEE检查的患者共110例。根据患者检查时心律情况分为窦性心律组和非瓣膜性房颤组。记录所有入选者的临床特征,TTE检查获得左心房前后径、左右径、上下径、左心房最大容积,左心室舒张末期前后径、左室射血分数,斑点追踪技术获取左心房储器期、管道期、泵功能期应变,左心室整体纵向应变等；TEE检查获取左心耳排空流速。比较两组间以上参数的差异,并采用Pearson相关性分析分别探讨两组患者LAAFV与TTE测得的左心房结构及功能参数的相关性及其差异。结果 最终90例患者纳入研究,其中窦性心律组60例,非瓣膜性房颤患者组30例。两组间性别、BMI指数无明显差异,房颤组平均年龄为(67.40±6.87)岁,明显大于窦性心律组(40.03±13.47)岁,P＜0.05；两组间左室射血分数(61.83±5.87%vs.65.94±6.20%)、左室整体纵向应变(-17.37±4.09%vs. -21.71±2.20%)、左房最大容积(68.83±22.84mlvs. 40.28±12.17ml)、左房储器期(15.53±9.41%vs. 34.91±7.15%)、管道期(-9.66±5.10%vs. -19.97±7.03%)、泵功能期(-6.07±6.22%vs. -14.72±4.74%)应变差异均有统计学意义(P＜0.05)。相关性分析中,两组患者左心房排空流速与左心房泵功能期应变均呈显著正相关(P<0.05),窦性心律组r值0.63、房颤心率组r值为0.62。结论 非瓣膜性房颤患者可出现左心房形态及功能改变,但无论非瓣膜房颤患者还是窦性心律人群,左心耳排空流速均与左心房泵功能呈正相关且相关程度一致。 |
| 关键词: 左心耳 排空流速 左心房功能 斑点追踪技术 超声心动图 |
| DOI： |
| 投稿时间：2023-01-03修订日期：2023-01-18 |
| 基金项目: |
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| Correlation Between Left Atrial Appendage Emptying Flow Velocity and Left Atrial Function in Patients with Different Heart Rhythms |
| liyongjia,hewen,zhangwei,zhouyixi,lantingyu,zhangmeng,zhanghuiqin,dulijuan |
| (Beijing Tiantan Hospital, Capital Medical University) |
| Abstract: |
| Objective To investigate the correlation between the left atrial appendage emptying flow velocity (LAAFV) and the left atrial function parameters in patients with non-valvular atrial fibrillation and sinus rhythm respectively, exploring the valuable non-interventional ultrasound parameters for left atrial appendage hemodynamic status. Methods 110 patients who presented to our hospital for atrial fibrillation or dizziness were selected. They all completed transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) at the same time. The patients were divided into sinus rhythm group and atrial fibrillation group according to their heart rhythm. The clinical characteristics were recorded. Left atrial diameters in different views, left atrial maximum volume, left ventricular internal dimension diastole and left ventricular ejection fraction were recorded. Speckle tracking technique was applied to obtain left atrial strain during reservoir phase, conduit phase, contraction phase and left ventricular global longitudinal strain. Left atrial appendage emptying flow velocity was gained from TEE. The differences of the observed parameters between the two groups were compared. Pearson correlation analysis was used to explore the correlation between the left atrial structural and functional parameters by TTE and LAAFV by TEE in the two groups respectively. Results 90 patients were finally included in the study, 60 were in sinus rhythm group and 30 in non-valvular atrial fibrillation group. There was no significant difference in gender or BMI between the two groups. The mean age in atrial fibrillation group was (67.40±6.87) years, significantly greater than that in sinus rhythm group ((40.03±13.47)years, p<0.05); the differences in left ventricular ejection fraction(61.83±5.87%vs.65.94±6.20%), left ventricular global longitudinal strain(-17.37±4.09%vs.-21.71±2.20%), left atrial maximum volume(68.83±22.84mlvs. 40.28±12.17ml), left atrial strain during reservoir phase (15.53±9.41%vs. 34.91±7.15%), conduit phase (-9.66±5.10%vs.-19.97±7.03%)and contraction phase(-6.07±6.22%vs. -14.72±4.74%)were all statistically significant (p<0.05). In correlation analysis, there was a significant positive correlation between left atrial emptying flow rate and left atrial strain during contraction phase in both groups (p<0.05), with r values of 0.63 in sinus rhythm group and 0.62 in atrial fibrillation heart rate group. Conclusion Patients with non-valvular atrial fibrillation may have altered left atrial morphology and function, but left atrial appendage emptying flow rate is positively correlated with left atrial contraction function in both non-valvular atrial fibrillation and sinus rhythm, and they are with the same extent. |
| Key words: Left atrial appendage Flow velocity Left atrial function Speckle tracking imaging Echocardiography |
