缺血性心肌病患者左心房功能改变的超声研究

Evaluating left atrial function in ischemic cardiomyopathy using acoustic quantification

目的 探讨超声对缺血性心肌病(ICM)患者左心房收缩及舒张功能改变的评价.方法 对34例ICM患者(NYHA心功能Ⅱ～Ⅳ级),采用声学定量(AQ)技术测量左心室舒张末期左心房容积(EDV)、左心室收缩末期左心房容积(ESV)、快速排空末期左心房容积(EREV)、左心房存储器容积即左心房总排空容积(LARV)、左心房快速排空容积(LARE)、左心房主动收缩排空容积(LAAE)、左心房快速排空分数(REF)、左心房主动收缩排空分数(AEF)、峰值充盈率(PFR)、峰值快速排空率(PRER)、峰值左心房排空率(PAER),并与34例正常人的上述各参数测值进行对比分析.结果 ICM组与正常组相比EDV、EREV、AEF有不同程度的升高(P＜0.01),ESV、LARV、LARE、LAAE、REF、PFR、PRER、PAER有不同程度的减低(P＜0.01或P＜0.05).结论 ICM患者左心房存储器功能和管道功能减低,助力泵功能代偿性增强,AQ技术为左心房功能的评价提供了无创性新方法.

Objective To evaluate left atrial (LA) systolic and diastolic function by acoustic quantification. Methods Thirty-four normal subjects were selected as the control group and 34 consecutive patients with a clinical diagnosis of ischemic cardiomyopathy (ICM) underwent echocardiography. Left ventricular end diastolic LA volume (EDV), Left ventricular end systolic LA volume (ESV), LA end rapid emptying volume (EREV), peak filling rate (PFR), peak rapid emptying rate (PRER) and peak atrium emptying rate (PAER) were measured , LA reservoir volume (LARV), LA rapid emptying volume (LARE), LA active emptying volume (LAAE), LA rapid emptying fraction (REF) and LA active ejection fraction (AEF) were calculated. Results Compared with the healthy controls, EDV, EREV and AEF were significantly increased (P<0.01), ESV, LARV, LARE, LAAE, REF, PFR, PRER and PAER were significantly decreased (P<0.01 or P<0.05). Conclusions In patients with ischemic cardiomyopathy, left atrial booster pump function was increased to compensate the impaired left ventricular function while conduit function and reservoir function were decreased. AQ technique may be used as a method for quantification of LA function in patients with ischemic cardiomyopathy.