左心耳充盈排空功能的超声研究

Assessment of the left atrial appendage function by tissue velocity imaging

目的:应用超声组织速度显像(TVI)技术对持续性房颤患者左心耳充盈和排空功能变化特点进行研究。方法:选择29例持续性房颤患者(房颤组)和31例对照者(对照组),在食管超声心动图(TEE)条件下获取左心耳超声图像,应用TVI技术对左心耳壁各节段收缩期峰值速度(PSV)和舒张早期峰值速度(PDVE)及其相关指标进行定量分析。结果:对照组左心耳壁顶部PSV和PDVE高于其余节段(P<0.05),房颤组左心耳壁各节段PSV和PDVE较对照组均降低(P<0.01)。对照组心耳顶部PSV与左心耳面积变化率(LAA-EF)和左心耳充盈速度(LAA-EV)呈正相关(r=0.656、0.712,P<0.001),房颤组心耳顶部PSV与左房腔内径(LADd)呈线性负相关(r=-0.66,P<0.001)。结论:TVI技术可定量评价左心耳排空及充盈功能,左心耳顶部PSV是反映左心耳整体排空功能的有效指标。

Objection： To assess the feasibility of measuring left atrial appendage （LAA） function with tissue velocity imaging in patients with persistent atrial fibrillation （AF）, and to explores its mechanical movement changes in pathological conditions. Methods： Thirty one controls and 29 patients with persistent AF are studied. Tissue velocity imaging （TVI） was performed with offline analysis in 5 segments of LAA wall. TVI detected a systolic （PSV） and diastolic （PDVE） deformation induced by LAA active motion. Results： At the tip of LAA, PSV and PDVE were higher than other segments in controls （P 〈0.01）. PSV and PDVE in AF group had no statistical difference in 5 segments of LAA （P 〉0. 05）. PSV in controls taken from the tip of the LAA was positively correlated with LAA-EV and LAA-EF （r = 0. 656, 0. 712, P 〈0. 001, respectively）. PSV in AF group taken from the tip of the LAA was negatively correlated with LAD （r =-0. 66,P 〈0. 001）. At the tip of LAA, PSV and PDVE were higher in controls than those in AF group （P 〈0.01）. Conclusion： TVI has high evaluative values in assessing LAA function. The tip PSV plays an important role in LAA emptying function.