经食管超声对窦性心律左心耳血流频谱的研究

目的　研究窦性心律左心耳血流频谱的类型 ,评价相应的血流动力学。方法　应用经食管超声技术 (TEE)对 83例窦性心律的左心耳血流频谱进行研究。结果　窦性心律左心耳血流频谱的波相可分为 4相、3相、2相三类。从 4相到 2相的演变过程中 ,左心房、左心耳扩大 ,左心房及左心耳功能降低 ,心率和年龄呈增加的趋势 ,左心房内自发性显像 (SEC)程度和血栓发生率均增加 ,风湿性心脏病、二尖瓣重度狭窄所占的比例也增加。多因素相关分析表明 :左心耳收缩期血流速度 (LAA A)与左心房面积 (S LA)、左心房容积 (V LA)呈负相关 ,与左心房面积变化率 (FAC)、左心房容积变化率 (EF LA)、左心耳容积变化率 (EF LAA)呈正相关。结论　窦性心律左心耳的血流频谱能较好地反映左心房、左心耳功能 ,在一定程度上反映了左心室的舒张功能。

Study of left atrial appendage flow wave patterns by TEE in sinus rhythm

Objective To study blood flow wave patterns of left atrial appendage in patients with sinus rhythm.Methods Transesophageal echocardiography (TEE) was performed to define characteristics of left atrial appendage flow wave patterns in 83 patients with sinus rhythm.Results Three different flow wave pattern were observed,consisting of quadriphasic pattern,triphasic pattern and biphasic pattern.In the process of changing from quadriphasic pattern to biphasic pattern,left atrial and left atrial appendage were enlarged,left atrial function and left atrial appendage function were decreased.Spontaneous echocardiographic contrast (SEC) and thromboembolism event were increased.The ratios of patients in rheumatic heart disease and severe mitral stenosis were increased too.There was a significant negative correlation between the peak early diastolic forward left atrial appendage flow velocity and left atrial size,as well as a significant positive correlation between the peak early diastolic forward left atrial appendage flow velocity and left atrial function.Conclusions Left atrial appendage flow wave patterns can reflect left atrial function,left atrial appendage function and left ventricular diastolic function.