非瓣膜性心房颤动患者CHA2DS2-VASc评分与左心耳功能关系的研究

Correlative analysis of CHA2DS2-VASc score and left atrial appendage function in patients with nonvalvular atrial fibrillation

心房颤动（房颤）是目前临床上最普遍发生的心律失常之一,随着患者年龄的增长,其发病率及病死率逐渐升高。长期的持续性房颤将会导致心房内血流动力学发生不良改变,左心耳血栓是其最常见的并发症。房颤发生时左心耳内的血栓脱落是血栓栓塞的主要危险因素,大量报道证实脱落的血栓与脑卒中事件有很强的相关性,约占缺血性卒中的15%。

In this study,we discussed the correlation of CHA2DS2-VASc score and left atrial appendage function in patients with non-valvular atrial fibrillation（AF）.From March 2013 to April 2015,150 patients were hospitalized and diagnosed as AF by dynamic electrocardiogram,of which 95 were persistent AF and 55 were nonpersistent AF.CHA2DS2-VASc score was obtained according to their general data and medical history.And TEE was used to assess the diameter of the systolic LAA orifice and left atrial appendage peak emptying flow velocity during diastolic phase.Values were compared and analyzed by statistical software.The 6out of 150 or 4% patients obtained a high CHA2DS2-VASc score（6points）,and 68patients（45.3%）scored low（≤3points）;there were 76 patients who scored 4to 6points,accounting for 50.7%.Compared with non-persistent AF patients,The CHA2DS2-VASc score of the patients with persistent AF was significantly higher,and their systolic LAA orifice was markedly larger with a remarkably reduced left atrial appendage peak emptying flow velocity during diastolic phase.Further,left atrial appendage thrombosis occurred in 8persistent AF and 3non-persistent AF patients;Spontaneous echocardiographic contrast was observed in 12 persistent AF patients and 8non-persistent patients.