二维斑点追踪技术对阵发房颤患者左心房功能的研究

目的：应用二维斑点追踪技术观察阵发房颤患者左心房功能的变化。方法：住院患者共63例，年龄39~83岁，平均（61.80±10.93）岁，男34例，女29例。阵发房颤组33例，对照组30例。所有患者均在窦性心律时行常规二维超声检查后应用Echo PAC软件脱机分析，测量左心房前后径、左心房面积、室间隔厚度、左心室前后径、左室射血分数；测量二尖瓣舒张末期A峰峰值速度及A峰积分。应用二维斑点追踪技术，获得左心房长轴方向整体应变曲线，测量左心房长轴整体峰值应变和达峰值应变时间、房缩期应变，计算两组间四腔观及二腔观达峰值应变时间差的绝对值。结果：应用二维斑点追踪技术比较两组间四腔切面及二腔切面达峰值应变时间差的绝对值，阵发房颤组较大（分别为52.83±32.29、31.33±20.27，P<0.05），阵发房颤组心房收缩期应变值较对照组减低[分别为-（10.09±3.33）、-（13.74±3.14），P<0.05]。结论：阵发房颤患者左心房心肌储存血液势能的能力不变，但心房壁间传导存在明显的不均一性，左心房整体的助力泵功能下降。二维斑点追踪技术能无创及定量评价左心房整体的功能异常。

Left atrium function in patients with paroxysmal atrial fibrillation: analysis from two-dimensional speckle tracking echocardiography

Objective：To observe the changes of left atrium（LA） function in patients with paroxysmal atrial fibrillation（AF） using two-dimensional（2D） speckle tracking echocardiography（STE）.Methods：The studied population consisted of 33 patients with paroxysmal AF and 30 age,sex-matched subjects in sinus rhythm（SR） referred to our echocardiography laboratory served as control group.All of the patients were in sinus rhythm when they were checked.Left atrial diameter（LAD）,left atrial area（LAA）,interventricular septum thickness（IVST）;left ventricular end-diastolic diameter（LVEDD） were measured in 2D echocardiography imaging.Left ventricular ejection fraction（LVEF） was determined.Mitral valve A wave velocity time integral（VTI-A） and maximum velocity（VA） were measured.LA wall strain in the longitudinal direction were obtained by using 2D-STE.Peak atrial longitudinal strain（PALS） and atrial contraction longitudinal strain（ACLS） were measured in apical 4-chamber view and apical 2-chamber view.Time to peak longitudinal strain（TPLS） were measured.△-TPLS was defined as the difference between the TPLS in apical 4-chamber view and apical 2-chamber view.Results：Compared with control group,△-TPLS were significantly increased in AF group（P0.05）.In patients with AF,ACLS were significantly decreased than that in the control group（P0.05）.Conclusions： LA reservoir function were remained but there were conductive asymmetry between atrial walls in patients with paroxysmal AF.AF also hurt LA cardiac muscle,LA pump function decreased significantly.2D-STE can effectively and easily measure LA △-TPLS and ACLS,speckle tracking echocardiography could be a method to non-invasively assess LA function in paroxysmal AF patients.