实时三维经食管超声心动图定量评价心房颤动患者左心耳形态及功能

目的探讨实时三维经食管超声心动图(RT-3D-TEE)定量评估心房颤动(AF)患者左心耳(LAA)形态和功能的可行性。方法选取56例拟接受射频消融术的阵发性AF患者(阵发组)、26例持续性AF患者(持续组)及同期11名健康人(对照组),采用RT-3D-TEE测量3组LAA各参数。结果与对照组比较,阵发组LAA舒张末期容积(LAA-EDV)、收缩末期容积(LAA-ESV)、开口最大面积(A_(max))及最小面积(A_(min))均增大,射血分数(LAA-EF)、最大排空速度(Vep)、面积变化率(A%)及直径变化率(D%)均减小(P均0.05);持续组LAA-EDV、LAA-ESV、A_(max)、A_(min)增大,LAA-EF、Vep、A%、D%减小(P均0.05);阵发组与持续组间各参数差异均无统计学意义(P均0.05)。LAA-EF与ESV (r=-0.73,P0.01)、EDV(r=-0.64,P0.01)、A_(max)(r=-0.36,P0.01)及年龄(r=-0.27,P=0.02)呈负相关,与A%、D%、Vep呈正相关(r=0.86、0.74、0.55,P均0.01),与D_(max)无明显相关(P0.05)。结论 RT-3D-TEE能定量分析AF患者LAA形态及功能变化,对于评估AF患者病情具有一定临床意义。

Quantitative evaluation of morphology and function of left atrial appendage in atrial fibrillation patients with real-time three-dimensional transesophageal echocardiography

Objective To investigate the feasibility of quantitative assessment of the left atrial appendage (LAA) morphology and function in atrial fibrillation (AF)patients with real-time three-dimensional transesophageal echocardiography (RT-3D-TEE). Methods Totally 56 patients with paroxysmal AF (paroxysmal group), 26 patients with sustained AF (sustained group) and 11 healthy controls (control group) were enrolled. RT-3D-TEE was used to measure LAA parameters of 3 groups. Results Compared with control group, LAA end-diastolic volume (LAA-EDV), end systolic volume (LAA-ESV), opening maximum area (A_max) and minimum area (A_min) of paroxysmal group increased, while LAA ejection fraction (LAA-EF), maximum evacuation speed (Vep), area change rate (A%) and diameter change rate (D%) of paroxysmal group decreased (all P<0.05). The sustained group LAA-EDV, LAA-ESV, A_max, A_min increased, LAA-EF, Vep, A%, D% decreased (all P<0.05). There was no significant difference between paroxysmal group and sustained group (all P>0.05). LAA-EF was negatively correlated with ESV (r=-0.73, P<0.01), EDV (r=-0.64, P<0.01), A_max (r=-0.36, P<0.01) and age (r=-0.27, P=0.02), positively correlated with A%, D% and Vep (r=0.86, 0.74, 0.55, all P<0.01), but not significantly correlated with D_max (P>0.05). Conclusion RT-3D-TEE can quantitatively analyze the changes of LAA morphology and function, and has certain clinical significance for evaluating the condition of AF patients.