声学定量方法动态评价房颤时右心房结构和功能的研究

目的：应用声学定量方法动态评价房颤时右心房结构和功能的变化。方法：通过快速心房起搏建立慢性房颤动物模型，采用声学定量方法（AQ）动态监测对照组（n=6只）和房颤组（n=8只）犬，起搏前、起搏1、4、8周时右心房容量－时间曲线。结果：与对照组相比，起搏4周后，房颤组右心室收缩末期右心房容积（ESV），右心室舒张末期右心房容积（EDV），右心房快速排空期末容积（EREV）开始增加，右心房射血分数（EF），右心房管道容积（CV）降低（P均＜0.05）；起搏8周后，ESV，EDV，EREV增加显著（P均＜0.001），而EF峰值、心房排空率（PAER）降低显著（P均＜0.001），CV亦明显降低（P＜0.05），余指标在起搏过程中无明显改变。与起搏前相比，房颤组起搏1周后右心房AQ各项指标均无明显改变（P＞0.05）；起搏4周后ESV、EREV、EDV增加（P＜0.05），EF降低（P＜0.05）；起搏8周后ESV、EREV、EDV显著增大（P＜0.001），EF和PAER降低（P＜0.001）；与起搏1周相比，起搏8周后ESV，EREV，EDV增大（P＜0.01），EF和PAER减低（P＜0.01）；余指标在起搏过程中差异无统计学意义。结论：房颤时右心房的助力泵功能和管道功能减低，而储存器功能无明显改变；AQ技术为无创性评价房颤时右心房结构和功能的改变提供了有效方法。

Dynamic evaluation of the right atrial structure and function in atrial fibrillation using the acoustic quantification technique

Objective: To evaluate the dynamic changes of the right atrial structure and function in atrial fibrillation using the acoustic quantification(AQ) technique.Methods: Dog models with chronic atrial fibrillation were established by rapid atrial pacing.Right atrial AQ waveforms were recorded before rapid atrial pacing and after pacing for 1,4 and 8 weeks.Results: Compared with the control group,ESV,EDV and EREV of the atrial fibrillation group were increased,and EF and CV were decreased(P<0.05) at 4 weeks after pacing.And 8 weeks after pacing, ESV,EDV and EREV were significantly increased(P<0.001),while EF and PAER significantly decreased(P<0.001) and CV was also significantly decreased(P<0.05), and the other parameters had no significant changes in the pacing progress.In the atrial fibrillation group,compared with those before pacing,right atrial AQ parameters had no significant changesat 1 week after pacing(P>0.05);ESV,EREV and EDV were significantly increased(P<0.05) and EF was significantly decreased (P<0.05) at 4 weeks after pacing,while ESV,EREV and EDV were significantly increased(P<0.001) and EF and PAER were significantly decreased(P<0.001) at 8 weeks after pacing.Compared with the 1-week group,ESV,EREV and EDV were significantly increased(P<0.01) and EF and PAER were significantly decreased(P<0.01) at 8 weeks after pacing,and other parameters had no statistical significance.Conclusions: Atrial fibrillation may result in right atrial booster pump and conduit function impairment but no changes of reservoir function.AQ technique may be used as a valuable noninvasive method for evaluating right atrial structure and function in atrial fibrillation.