实时三维超声心动图评估阵发性房颤患者左房功能的研究

Evaluation of left atrial function in patients with paroxysmal atrial fibrillation by real-time three-dimensional echocardiography

摘要:

目的  探讨实时三维超声心动图（RT-3DE）评估阵发性房颤患者左心房功能的研究。方法  45例阵发性房颤患者为病例组，43例正常人为对照组。所有患者行常规超声心动图检查，获取左房径线、二尖瓣血流频谱E波和A波速度、E波与A波的速度比值（E/A），应用组织多普勒获得二尖瓣瓣环室间隔侧、侧壁侧瓣环舒张早期速度峰值（Ve）、舒张晚期速度峰值（Va）。应用实时三维超声心动图采集动态图像，脱机分析计算左房最大容积（LAVmax）、左房最小容积（LAVmin）、左房收缩期前容积（LAVpreA）、左房储蓄容积（ARV）、左房主动排空容积（AEV）。结果  与正常对照组比较，阵发性房颤组的LA径线、VE、E/e、LAVmax、LAVpreA和LAVmin显著增大，而ARV/LAVmax、AEV/LAVpreA明显减少，差异有统计学意义（P <0.05）。结论  实时三维超声心动图检测证实阵发性房颤患者的左房的储备功能及辅助泵功能有明显障碍。

关键词:

实时三维超声心动图;心房颤动;左房功能

Abstract:

Objective To evaluate the left atrial functions on diagnosis of paroxysmal atrial fibrillation (PAF) by real-time three dimensional echocardiography (RT-3DE). Methods Eighty-eight patients with [n = 45, 28 men, age (52.6 ± 11)] or without [n = 43, 27 men, age (50.8 ± 9)] PAF were studied. Parameters of left atrial size (LA size), E and A velocities and E/A ratio were obtained by two-dimensional echocardiography; and Ve and Va at the septum and lateral edge of the mitral annulus were recorded by tissue Doppler. The maximal left atrial volume (LAVmax), minimal left atrial volume (LAVmin), pre-atrial contraction left volume (LAVpreA), atrial reservoir volume (ARV) and active empty volume (AEV) were measured off-line by RT-3DE. Results Compared to normal controls, LA diameter, Ve, E/e, LAVmax, LAVpreA, and LAVmin significantly increased in patients with PAF; and ARV/LAVmax and AEV/LAVpreA significantly decreased (P < 0.05). Conclusions RT-3DE confirmed that LA reservoir function and booster pump function are impaired in patients with PAF.

Key words:

real-time three-dimensional echocardiography; atrial fibrillation; left atrial function