多普勒超声联合M型超声评价心房颤动复律后心房顿抑和心房功能

目的　应用心肌组织多普勒成像 (TDI)结合M型超声、脉冲多普勒及心尖搏动图测定房室环运动速度及幅度、跨瓣血流速度及压力变化 ,评价心房颤动 (房颤 )复律后心房功能的恢复及心房顿抑的发生。方法　房颤患者 3 4例于复律后 1h、1d、1周及 1个月行超声检查 ,并与正常组对照。采用TDI技术测量房室环游离壁舒张晚期即心房收缩期心肌组织运动峰速 (Am )、舒张早期即心室主动舒张期心肌组织运动峰速 (Em ) ,并计算Am/Em值 ;M型超声测量房室环游离壁舒张晚期心肌最大运动幅度 (DAD)、舒张早期心肌最大运动幅度 (DED) ,并计算DAD/DED值 ;脉冲多普勒测量A峰血流速度、E峰血流速度并计算A/E值 ;心尖搏动图记录心房收缩压力波。结果　复律后左右心房功能均低于正常 (P <0 .0 5 ) ,并随时间逐渐恢复 ,至 1周右房功能基本恢复正常 ,1个月左房功能恢复正常。心房顿抑的发生率在左房复律 1h时为 2 0 .6% ,1d 11.76% ,1周 6.5 % ;右房则在 1h和 1d均为 14 .7% ,1周 3 .2 % ,1个月时左右心房均无心房顿抑。结论　房颤复律后左右心房功能均低于正常 ,且均有心房顿抑发生。左房功能 1个月恢复正常 ,右房功能 1周恢复正常

Evaluating atrial stunning and atrial function after cardioversion of atrial fibrillation with tissue Doppler,pulsed Doppler and M-mode echocardiography

Objective To evaluate atrial stunning and the recovery of atrial function after successful cardioversion in the patients with atrial fibrillation by utilizing tissue Doppler imaging(TDI) and M-mode echocardiography in atria-ventricular annulus motion, together with pulsed Doppler echocardiography and apexcardiogram. Methods Thirty-four patients with atrial fibrillation received ultrasound examinations in 1 hour,1 day,1 week and 1 month after successful cardioversion. The results were compared with those of 20 age-matched healthy individuals. From the echocardiography apical 4-chamber views, the atrial mechnical activities in the mitral and tricuspid annulus were recorded using two-dimensional echocardiography guided M-mode and TDI. Furthermore, pulsed Doppler transmitral and transtricuspid inflow velocity and apexcardiogram were also recorded. Atrial stunning means the lack of atrial mechanical function after atrial electrical activity was recovered with successful cardioversion. Results Left and right atrial functions after cardioversion were both inferior to those of the healthy ones,but improved with time,up to 1 week right arial function turned basically to normal and 1 month left one recovered to normal.The incidence of atrial stunning in left and right atrium accounted for (20.6)% and (14.7)% respectively at 1 hour after successful cardioversion, (11.76)% and (14.7)% at 1 day, (6.5)% and (3.2)% at 1 week. Conclusions Both left and right atrial functions are lower than the normal after cardioversion,and atrial stunning happens in both atria.Left and right atria recover to normal respectively in 1 month and 1 week.