心房颤动对左心瓣膜置换术后心脏重构的影响

Impact of atrail fibrillation in cardiac remodelling after left heart valve replacement

目的使用超声心动图评价心房颤动对左心瓣膜置换术后心脏结构和功能重构的影响。方法100例行左心瓣膜置换术的二尖瓣或双瓣(二尖瓣合并主动脉瓣)病变患者,于术前1周、术后1周、术后6个月行超声心动图随访,93例患者完成随访,其中38例为窦性心律,55例为心房颤动。超声测量并计算左、右心房容积(LAV、RAV)、左、右心室射血分数(LVEF、RVEF),按照测量时间进行分组比较。结果术后窦性心律组(SR组)和心房颤动组(AF组)患者左、右心房容积均较术前减小(P<0.05);手术前后AF组的左、右心房容积、左心室射血分数均大于SR组(P<0.05)。结论二尖瓣或双瓣病变合并心房颤动的患者心脏结构和功能受损较窦性心律患者重,术后左心功能和双房大小的恢复较窦性心律患者差。

Objective To evaluate the structure and function of heart valve by echocardiography and analyze impact of atrail fibrillation in cardiac anatomic and function reconstruction after left heart valve replacement. Methods A total of 100 patiertts with left heart valve disease were performed by echocardio- graphy before valve replacement surgery, 1 week after surgery and 6-9 months of follow-up. Ninety-three cases received the whole follow-up including 38 patients with sinus rhythm and 55 patients with atrial fibrilla- tion. Left, right atrium volume and left, right ventricle ejection fraction were measured. The groups were classified according to measurement time. Results Both sinus rythm group and atrail fibrillation group, left atrium volume and right atrium volume decreased （ P 〈 0.05 ） , but there were no significant change in LVEF in sinus rythm group and significant change in RVEF in atrail fibrillation group （ P 〉 0.05 ）. There were significant differences in LAV, RAV, LVEF between sinus rythm group and atrail fibrillation group （P 〈 0.05） before and after dperation. Conclusions The cardiac structure and function remodeling of sinus rythm group are better than atrial fibrillation group.