经胸和经食管超声心动描记术评价房颤栓塞危险性

Estimating embolic risk in atrial fibrillation by transthoracic and transesophageal echocardiography

目的 比较经胸超声心动描记术 (TTE)和经食管超声心动描记术 (TEE)评价房颤栓塞危险性的价值。 方法 对 10 6例心房颤动患者同时进行TTE和TEE检查 ,根据TEE检查结果分为血栓阳性组和血栓阴性组。对两组间左房自发性超声显影 (leftatrialspontaneousechocontrast,LASEC)的严重程度 ,LA内径 ,LVd ,LVs ,FS和二尖瓣瓣口面积等进行比较。 结果 10 6例中经TEE检查发现 14个血栓 ,而TTE检查仅发现 4个血栓 ,两组间LASEC的严重程度、LA内径、二尖瓣瓣口面积均有显著性差异。相关分析显示LASEC与LA内径呈显著正相关 ,与二尖瓣瓣口面积显著负相关。 结论 TEE对于房颤患者血栓的检测及栓塞危险性的评估较TTE更有优势 ,LASEC分级、LA内径、二尖瓣瓣口面积可作为房颤患者左房血栓形成的预示因子。

Objective To compare the value of estimating embolic risk in atrial fibrillation between the two methods: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Methods TTE and TEE examination were performed on 106 patients with artial fibrillation. The patients were divided into two guoups according to the TEE findings: groupⅠ(with atrial thrombus, n=12)and groupⅡ (without atrial thrombus , n=94). TTE and TEE parameters such as left atrial spontaneous echocontrast( LASEC)、left atrial (LA) diameter、LVd、LVs、FS and mitral valve area of the two groups were compared. Results Fourteen atrial thrombi were detected by TEE, but only 4 were detected by TTE. There were significant differences between groupⅠand groupⅡin grades of LASEC,LA diameter and mitral valve area. The severity of LASEC was correlated positively with LA diameter and negatively with mitral valve area. Conclusion Compared to TTE, TEE appears to be a more helpful method for detecting atrial thrombus and evaluating embolic risk. The grades of LASEC,LA diameter and mitral valve area can be regarded as the predictors to determine the occurrence of the left atrial thrombus in patients with atrial fibrillation.