非瓣膜性心房颤动患者及窦性心律者左心耳排空流速与左房功能参数的相关性研究

目的 应用经食管超声心动图(TEE)检测非瓣膜性心房颤动(以下简称房颤)患者及窦性心律者左心耳排空流速(LAAFV)，探讨其与经胸超声心动图(TTE)所测左房功能参数的相关性。方法 选取我院窦性心律者60例(窦性心律组)和非瓣膜性房颤患者30例(房颤组)。应用TTE获取左房收缩末期前后径(LADd_前后)、左右径(LADd_左右)、上下径(LADd_上下)，以及左室舒张末期内径、左室射血分数(LVEF)；斑点追踪技术获取左房储器期应变(LASr)、管道期应变(LAScd)、泵功能期应变(LASct)，以及左室整体纵向应变(LVGLAS)、左房收缩末期最大容积(LAVmax);TEE检测LAAFV。比较两组上述各参数的差异；分析窦性心律组和房颤组LAAFV与TTE所测左房功能参数的相关性。结果 房颤组LVEF、LVGLAS、LASr、LAScd、LASct、LAAFV均小于窦性心律组，LADd_前后、LADd_左右、LADd_上下、LAVmax均大于窦性心律组，两组比较...

Correlation Between Left Atrial Appendage Emptying Flow Velocity and Left Atrial Function in Patients with Different Heart Rhythms

Objective To investigate the correlation between the left atrial appendage emptying flow velocity (LAAFV) and the left atrial function parameters in patients with non-valvular atrial fibrillation and sinus rhythm respectively, exploring the valuable non-interventional ultrasound parameters for left atrial appendage hemodynamic status. Methods 110 patients who presented to our hospital for atrial fibrillation or dizziness were selected. They all completed transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) at the same time. The patients were divided into sinus rhythm group and atrial fibrillation group according to their heart rhythm. The clinical characteristics were recorded. Left atrial diameters in different views, left atrial maximum volume, left ventricular internal dimension diastole and left ventricular ejection fraction were recorded. Speckle tracking technique was applied to obtain left atrial strain during reservoir phase, conduit phase, contraction phase and left ventricular global longitudinal strain. Left atrial appendage emptying flow velocity was gained from TEE. The differences of the observed parameters between the two groups were compared. Pearson correlation analysis was used to explore the correlation between the left atrial structural and functional parameters by TTE and LAAFV by TEE in the two groups respectively. Results 90 patients were finally included in the study, 60 were in sinus rhythm group and 30 in non-valvular atrial fibrillation group. There was no significant difference in gender or BMI between the two groups. The mean age in atrial fibrillation group was (67.40±6.87) years, significantly greater than that in sinus rhythm group ((40.03±13.47)years, p<0.05); the differences in left ventricular ejection fraction(61.83±5.87%vs.65.94±6.20%), left ventricular global longitudinal strain(-17.37±4.09%vs.-21.71±2.20%), left atrial maximum volume(68.83±22.84mlvs. 40.28±12.17ml), left atrial strain during reservoir phase (15.53±9.41%vs. 34.91±7.15%), conduit phase (-9.66±5.10%vs.-19.97±7.03%)and contraction phase(-6.07±6.22%vs. -14.72±4.74%)were all statistically significant (p<0.05). In correlation analysis, there was a significant positive correlation between left atrial emptying flow rate and left atrial strain during contraction phase in both groups (p<0.05), with r values of 0.63 in sinus rhythm group and 0.62 in atrial fibrillation heart rate group. Conclusion Patients with non-valvular atrial fibrillation may have altered left atrial morphology and function, but left atrial appendage emptying flow rate is positively correlated with left atrial contraction function in both non-valvular atrial fibrillation and sinus rhythm, and they are with the same extent.