孤立性心房颤动患者左右心室功能的研究

Evaluation of ventricular function in patients with lone atrial fibrillation by echocardiography

目的应用定量组织速度成像技术(QTVI)联合二尖瓣环收缩期位移(MAD)及三尖瓣环收缩期位移(TAPSE)评价孤立性心房颤动(LAF)患者左、右心室功能。方法 LAF组为36例患者(左、右心室结构正常),对照组为30名健康成年人,应用M型超声测量左、右心室结构常规参数,MAD及TAPSE;应用多普勒超声测定二、三尖瓣瓣口舒张期峰值血流速度E;应用QTVI测量左心室侧壁二尖瓣环处、右心室侧壁三尖瓣环处收缩期峰值速度Vs,舒张期峰值速度Ve,并计算E/Ve。结果与对照组相比,LAF组左心室E、E/Ve升高,Ve、Vs、MAD减低(均为P<0.05),LAF组右心室E、E/Ve升高,Ve、Vs、TAPSE值减低(均为P<0.05),IVSTd、LVPWTd、LVEDD、LVESD、LVEF、RVD1、RVD2、RVD3、RVAW、RVEF各组间差异无统计学意义(均为P>0.05)。结论 LAF组较对照组左、右心室功能均受损。

Objective To evaluate the ventricular function in patients with lone Atrial Fibrillation （LAF） by quantitative Tissue Velocity Imaging （QTVI） , mitral annular displacement （MAD）and tricuspid annular plane systolic excursion （TAPSE）. Methods Thirty-six patients with LAF served as experimental group. Thirty normal volunteers served as control group. The values of right ventricle （RV） and left ventricle （LV） , MAD and TAPSE were evaluated by M-mode ultrasound. Left ventricular ejection fraction （LVEF） and right ventricular ejection fraction （RVEF） were calculated by Simpson＇s method. Mitral inflow velocity and tricuspid inflow velocity （E） were measured by Doppler echoeardiography. QTVI derived systolic mitral annular velocity, systolic tricuspid annular velocity （Vs）, diastolic mitral annular velocity, diastolic tricuspid annular velocity （Ve）, and the ratio of diastolic mitral inflow velocity to Ve and diastolic tricuspid inflow velocity to Ve （E/Ve） were calculated. Results Compared with the values in control group,the E, E/Ve of LV were significantly higher and the Ve, Vs and MAD of LV were significantly lower in LAF group （ all P 〈 0. 05 ）. Compared with the values in control group, the E, E/Ve of RV were significantly higher and the Ve, Vs and TAPSE of RV were significantly lower in LAF group （ all P 〈 0. 05 ）. There were no differences in IVSTd, LVPWTd, LVEDD, LVESD, LVEF, RVD1, RVD2, RVD3, RVAW, RVEF between groups （all P 〉 0. 05）. Conclusions Both LV and RV functions are impaired in patients with LAF.