房颤时左心耳结构和功能改变与肺静脉血流的关系研究

The Relationship between Pulmonary Venous Flow and Changes of Left Atrial Appendage in Atrial Fibrillation

目的评价房颤时左心耳结构和功能改变与肺静脉血流变化的关系。方法74例房颤患者和16例正常人接受经胸超声心动图(TTE)和经食道超声心动图(TEE)检查,检测左心耳血栓形成、结构、功能和肺静脉血流频谱指标。结果18例房颤患者存在左心耳血栓,血栓组、非血栓组和正常组间左心耳结构、功能和肺静脉血流频谱有显著差异,其中血栓组左心耳扩大,血流速度下降最严重,左心耳结构、功能和肺静脉血流密切相关。结论房颤时左心耳结构改变,功能减退,肺静脉血流和左心耳结构、功能关系密切,能准确反应左心耳功能,在血栓评价中具有重要意义。

Objective To observe the relationship between pulmonary venous flow （PVF） and the changes of left atrial appendage（LAA） in atrial fibrillation（AF） patients. Methods Transthoracic and transesophageal echocardiography （TIE and TEE） were performed in 16 healthy persons and 74 patients with chronic AF to define the PVF changes and relationship of PVF and LAA in AF. Results Thrombus was found in left atrlal/atrial appendage in 18 AF patients by TEE. PVF slow, LAA dilation and poor contraction were found in AF patients, especially in those with thrombus. Significant correlation was found among LAA enlargement, left atrial dysfunction and reduced PVF in AF. Conclusiorts LAA is dilated and contraction is damaged in AF patients. PVF is useful to identify AF patients with high thrombus risk and can reflect LAA dysfunction in atrial fibrillation.