超声评价孤立性心房颤动患者血管内皮功能

Ultrasonographic evaluation of vascular endothelial function in patients with lone atrial fibrillation

目的探讨超声评价孤立性心房颤动(AF)患者血管内皮依赖性舒张功能的临床应用价值。方法应用超声多普勒技术测量32例孤立性AF患者(孤立性AF组)及25名健康志愿者(正常对照组)反应性充血及含服硝酸甘油后的肱动脉内径变化,计算百分变化率,并测量左心房容积。结果孤立性AF组充血试验诱发的肱动脉内径百分变化率(FMD)与正常对照组相比明显减小[(6.14±2.03)%vs(16.50±5.00)%,P<0.01],两组受试者含服硝酸甘油后肱动脉内径百分变化率(NTG-MD)差异无统计学意义(P>0.05)。孤立性AF组与正常对照组相比左心房容积明显增大[(45.85±13.72)mlvs(27.33±6.51)ml,P<0.01]。孤立性AF患者FMD与左心房容积呈负相关(r=-0.62,P<0.01)。结论 AF对血管内皮依赖性舒张功能有损伤作用,孤立性AF患者FMD与左心房构型有关。

Objective To explore the clinical value of ultrasound in assessment of the endothelial function in patients with lone atrial fibrillation（AF）.Methods Thirty-two patients with lone AF and 25 healthy subjects matched in age and gender were enrolled.Endothelial function was evaluated with flow-mediated vasodilation（FMD）and after sublingual nitroglycerin administration-mediated vasodilation（NTG-MD）of brachial artery with ultrasound.Left atrium volume was measured in all subjects with echocardiography.Results FMD of brachial artery in patients with lone AF were significantly lower than that in the healthy subjects（[6.14±2.03]% vs [16.50±5.00]%,P〈0.01）.NTG-MD of brachial artery in patients with lone AF had no significant difference with that in the healthy subjects（P〉0.05）.Left atrium volume of the patients with lone AF was significantly higher than that of the healthy subjects（[45.85±13.72]ml vs [27.33±6.51]ml,P〈0.01）.FMD of brachial artery showed significant correlation with left atrium volume in patients with lone AF（r=-0.62,P〈0.01）.Conclusion Lone AF has depressive effect on endothelial dependent dilation.There is correlation between FMD of brachial artery and left atrium volume in all patients with lone AF.