心房颤动持续时间与心脏结构及功能改变的相关性研究

目的分析阵发及持续性心房颤动患者超声心动图的改变，探讨心房颤动持续时间与心脏结构及功能改变的相关性。方法通过动态心电图筛选出持续性心房颤动组、阵发性心房颤动组及窦性心律组患者，各60例，比较三组患者超声心动图左心房前后径（LAD）、室间隔厚度（VST）、左心室射血分数（LVEF）的差异。结果与窦性心律组（29．7±3．8）mm及阵发性心房颤动组（33．4±5．2）mm相比，持续性心房颤动组LAD明显增加[（44．1±4．7）mm，P〈0．05]；VST在窦性心律组、阵发性心房颤动组、持续性心房颤动组之间无明显差别（P〉0．05）。与窦性心律组相比，持续性心房颤动组LVEF减低，差异有统计学意义（P〈0．05）；窦性心律组与阵发性心房颤动组无明显差别。结论LAD及LVEF的改变与心房颤动持续时间密切相关，心房颤动导致的解刹重构以及心室率不规则和频率较快是其改变的主要原因。

The study of correlation between atrial fibrillation duration and cardiac structural as well as function alteration

Objective To analyze the echocardiographic characteristics of patients with paroxymal and permanent atrial fibrillation （AF）, and to investigate the correlation between duration of AF and cardiac structural as well as function alteration. Methods Paroxymal and Permanent AF patients, as well as examinee with sinus rhythm were randomly screened and recruited by 24-hour ambulatory ECG. Each group was consisted of 60 subjects. Left atrial dimeter （LAD）, ventricular septal thickness（VST）, and Left ventricular ejection fraction（LVEF） were compared among three groups. Results Compared with sinus rhythm （29.7±3.8）mm and paroxymal AF （33.4±5.2）mm,LAD of permanent AF [（44.1±4.7）mm,P〈0.05] significantly increased （P〈0.05）,however,there was no difference on VST among sinus rhythm （8.8＋4.9）mm,paroxysmal AF（9.9±2.4）mm and permanent AF（10.7±2.4）mm （P〉0.05）. LVEF of permanent AF （57.7±8.7%） remarkably decreased when compared with that of sinus rhythm [（64.7±6.4）% ,P〈0.05] ,no difference was observed between sinus rhythm and paroxymal AF（62.7±7.8）%. Conclusions Alteration of LAD and LVEF is closely associated with duration of AF, which could be resulted from AF-induced atrial remodeling and irregular, rapid ventricular response.