阵发性房颤复律后左心耳功能变化及其影响因素的研究

目的研究阵发性心房颤动患者自动复律后左心耳功能变化及其影响因素。方法应用经食管超声心动图检测38例阵发性房颤患者复律后当日和复律后第7天的左心耳血流最大排空速度，同时测定血浆心钠素、房颤持续时间、左房内径等其他指标，并与20例正常对照组作比较。结果阵发性房颤患者复律当日左心耳血流最大排空速度（35．95±5．48）cm／s，明显低于复律后1周时（63．03±5．64）cm／s及正常对照组（64．37±6．93）cm／s，复律后1周时与正常对照组差异无统计学意义；多因素回归分析显示房颤持续时间、心钠素是复律当13左心耳血流最大排空速度的独立影响因素。结论阵发性房颤存在左心耳功能顿抑，其严重程度同房颤持续时间及心钠素水平有关。

Objective To investigate the changes of left atrial appendage function after auto - converting to sinus rhythm in patient with paroxysmal atrial fibrillation （PAF） as well as its influential factors. Methods Left atrial appendage peak emptying velocity （ LAA - PEV） on the first day as well as one week later after auto - converting to sinus rhythm in 38 patients with PAF were evaluated by means of transesophageal echocardiography. Some possible influence factors including Plasma levels of atrial natriuretic peptide （ ANP）, lasting time of PAF and left atrium diamater were also measured. Normal control subjects （ 30 persons without any disease）were also included in this study. Results LAA - PEV on the first day after auto - converting to sinus rhythm was lower than that measured one week later after auto - converting to sinus rhythm（ 35.95 ± 5.48vs63.03± 5.64, P 〈 0. 01 ）, LAA - PEV measured one week later after auto - converting to sinus rhythm in patients with PAF was the same as that measured in normal control subjects（63.03 ±5.64vs64.37±6.93 ,P 〉0.05）. Lasting time of AF and level of ANP（P =0. 007） were independently associated with LAA - PEV on the first day after auto - converting to sinus rhythm. Conclusion Left atrium appendage stunning is found in patient with PAF, which is influenced by lasting time of AF and level of ANP.