老年阵发性房颤患者心脏舒张功能变化的研究

Clinical research of left ventricular diastolic function in elderly patients with paroxysmal atrial fibrillation

目的探讨老年阵发性心房颤动(PAF)患者在窦性心律状态下心脏舒张功能的变化。方法选取28名有PAF发作史的老年心脏病患者与25名无AF发作史的老年体检者,运用心脏超声与核素心室显像分别测定2组患者的心脏舒张功能指标。结果心脏超声检查PAF组与对照组比较E/A明显降低[(0.52±0.03)、(0.95±0.08),P<0.05];心室等容舒张时间(IVRT)明显延长[(129.63±12.66)ms、(102.56±9.68)ms,P<0.05];左心房内径(LAD)明显增加[(43.78±3.89)mm、(37.96±3.75)mm,P<0.05];而2组的左室射血分数(LVEF)无明显差异[(58.35±4.82)%、(60.26±5.69)%,P>0.05];核素心室显像检查高峰充盈率(PFR)明显降低[(2.89±0.16)EDV/s、(3.68±0.26)EDV/s,P<0.05];1/3充盈分数(1/3FF)明显下降[(32.28±1.82)%、(45.93±3.86)%,P<0.05]。结论老年PAF患者在窦性心律时伴有心脏舒张功能的降低。

Objective To study the change of left ventricular diastolic function under sinus rhythm in elderly patients with paroxysmal atrial fibrillation（PAF）. Methods E/A ratio, isovolumic relaxation time （IVRT）, left atrial dimension （LAD） and left ventricular ejection fraction（LVEF） were measured with echocardiogram and peak filling rate （PFR） and 1/3 filling fraction（1/3FF） were measured with nuclear cardiac angiography in 28 elderly patients with PAF and in 25 elderly patients without history of AF （control）. Results E/A ratio was significantly lower in PAF than that in control（0. 52 ± 0. 03 versus 0. 95± 0. 08, P 〈 0. 05 ）, and IVRT was significantly longer in PAF than that in control （ 129.63± 12. 66 versus 102. 56±9.68ms, P 〈0.05 ）. LAD was significantly higher in PAF than that in control（43.78 ± 3.89 versus 37. 96 ± 3.75 mm, P 〈 0. 05 ）. PFR and 1/3 FF were significantly lower in PAF than those in control （ PFR ： 2.89±0. 16 versus 3.68 ± 0.26EDV/s,P〈0. 05;1/3FF： 32.28±1.82 versus 45.93±3.86%,P〈0.05）. Conclusions The left ventricular diastolic function is decreased under sinus rhythm in elderly patients with PAF.