房颤心室率对超声测量左室收缩功能的影响

Effect of atrial fibrillation on assessment of left ventricular systolic function by echocardiography

[目的]探讨房颤伴不同心室率对常规超声方法测量左室收缩功能的影响。[方法]连续收录阵发性房颤患者30例，分别于房颤发作时和窦性心律时行心脏超声检查，存储3—10个心动周期的动态图像，测量各腔室内径及左室射血分数（LVEF），进行比较分析。[结果]所有患者均有不同程度的左房增大；单个患者，房颤伴不同心室率时经胸超声双平面Simpson’s法测得的LVEF变化范围可达12％～40％，合并心衰时。LVEF受影响更大。随心室率由慢到快，测得的LVEF呈类“ ”型曲线，最接近窦律下测得的LVEF的RR间期范围是806～1010（910±72）ms（对应的心室率74～59次／min），而心脏每搏输出量随RR间期的延长而逐渐增加。[结论]超声心动图评估房颤患者的心脏收缩功能时不仅要考虑到其基础心脏状态，选择合适的心率范围也很重要。

[ Objectives ] To detect the effect of atrial fibrillation with different ventricular rate on the assessment of left ventricular systolic function by routine echocardiography. [ Methods ] Continuously enrolled 30 cases of paradoxical atrial fibrillation. Echocardiography were underwent in sinus rhythm and atrial fibrillation, respectively. Dynamic images in 3 - 10 cardiac cycles were stored for analyses. [ Results ] Left atrial enlargement was seen in all patients with various degree. In one patient, the measured LVEF could range from 12% to 40% with various ventricular rate, especially when combined with heart failure. With slow to fast ventricular rate, the measured LVEF was shown as a ＂ ＂ like curve. The RR interval when LVEF was closest to what detected in sinus rhythm was 806 - 1010 （910 ± 72）ms, while the stroke volume increased with the elongation of RR interval. [ Conclusion] When assessing the left ventricular systolic function by eehocardiography, not only the basic cardiac status, but also reasonable heart rate should be considered.