心电图心房颤动波分度值与左心房大小的相关性研究

Relationship between Fractal Dimension of Atrial Fibrillation and Left Atrial Size

目的探讨心电图心房颤动(房颤)波分度值(D值)与左心房大小的相关性。方法选择经M型超声心动图及心电图检测的53例慢性房颤(病史超过1年)患者(其中风湿性心脏病27例,冠状动脉粥样硬化性心脏病及其他疾病如甲亢性心脏病等26例),在左室长轴切面上选择Ⅳ区,取M型超声心动图曲线,测量左心房前后径,同时运用数学里分度的方法求出各种心电图房颤波D值,将D值与左心房大小进行相关分析。结果 D值大小和左心房大小呈正相关(r=0.66,P<0.05)。当D值大(>1.14),左心房均≥4.6 cm;当D值小(<1.09),左心房均≤4.6 cm;当1.09<D值<1.14,D值大小与左心房大小无明确联系。D值越大,引起心电图房颤波的不规则度、粗糙度及复杂度越高,左心房也越大,多见于风湿性心脏病患者;相反,D值越小,左心房也越小,多见于冠状动脉粥样硬化性心脏病及其他患者如甲状腺功能亢进症等。结论房颤患者D值的计算,可从慢性房颤患者的心电图房颤波中进行;D值的大小可预测患者左心房的大小。

Objective To explore the relationship between fractal dimention（D） of atrial fibrillation and left atrial size.Methods D was calculated in 53 patients with chronic atrial fibrillation（27 patients with rheumatic heart disease,26 patients with coronary heart disease or other diseases such as hyperthyroid heart disease;more than one year of duration）.Left atrial size was determined by standard M-mode echocardiograms of left ventricular long axis view.Results D was positively correlated with left atrial size（r=0.66,P0.05）.When D was large（greater than 1.14）,all patients had a left atrial size of 4.6 cm or greater.When D wes small（less than 1.09）,all patients had a left atrial size of 4.6 cm or smaller.Values of D between 1.09 and 1.14 were not correlated with left atrial size.Larger values of D were associated with a higher degree of irregularity,roughness,and complexity in the surface ECG rhythm strips.Smaller values of D were associated with a smaller left atrail size,which was common in patients with coronary heart disease and other disorders such as hyperthyroidism.Conclusion In patients with chronic atrial fibrillation,D derived from the surface ECG may be useful in predicting left atrial size.