二维斑点追踪成像评价年龄与健康成人心房内和心房间电-机械运动同步性的关系

目的应用二维斑点追踪成像评价年龄与健康成人心房内和心房间电-机械运动同步性的关系。方法获取入选者标准心尖四腔切面的动态超声心动图图像，分析右心房游离壁、房间隔和左心房游离壁的斑点追踪图像，测量心电图P波起始点至斑点追踪图像上A波起始点的时间，分别为右心房游离壁电-机械运动达峰时间（P-RA）、房间隔电-机械运动达峰时间（P-IAS）与左心房游离壁电-机械运动达峰时间（P-LA），并根据公式计算心房内和心房间同步性。比较不同年龄者P-RA、P-IAS、P-LA与心房同步性参数的差异，并进一步分析P-RA、P-IAS、P-LA和心房同步性参数与年龄间的关系。结果健康成人无论年龄大小，P-RA最短，P-LA最长，而P-IAS介于P-RA与P-LA间。随年龄增加，P-RA、P-IAS、P-LA呈逐渐延长趋势，其中老年组与青年组间P-IAS、中年组与青年组间的P-LA、老年组与青年组间的P-LA与老年组与中年组间的P-LA差异有统计学意义。随年龄增加，右心房房内同步性、左心房房内同步性和左右心房间同步性呈逐渐降低趋势，其中老年组与青年组间的右心房房内同步性、中年组与青年组间的左心房房内同步性、老年组与青年组间的左心房房内同步性、老年组与中年组间的左心房房内同步性、中年组与青年组间的左右心房间同步性、老年组与青年组间的左右心房间同步性和老年组与中年组间的左右心房间同步性差异有统计学意义。入选者P-RA、P-IAS、P-LA、右心房房内同步性、左心房房内同步性、左右心房间同步性与年龄均有显著相关性，其中左心房房内同步性和左右心房间同步性与年龄的相关性最好。结论心房同步性随着年龄改变而发生明显变化，且与年龄密切相关。

Objective To evaluate the relationship between age and synchrony of intra-atrial and inter-atrial electro-mechanical motion in normal adults by two dimensional speckle tracking imaging. Methods A dynamic echocardiographic image of the standard apical four chamber view was obtained and the speckle tracking imaging of the right atrium free wall, atrial septum and left atrium free wall was analysed online. The time from the onset time of P wave to the onset time of A wave of speckle tracking image was measured, the peak time of electrical mechanical motion of the right atrium free wall （ P-RA ） , atrial septum （ P-IAS ） and left atrium free wall （ P-LA ） , respectively. The synchrony of intra-atrial and inter-atria/electro- mechanical motion based on the formula was calculated. The differences of P-RA, P-IAS, P-LA and atrial synchrony parameters between different age groups were compared and the relationship between P-RA, P-IAS, P-LA and atrial synchrony parameters and age was analysed. Results P-RA was the shortest and P-LA longest, while P-IAS was between P-RA and P-LA in normal adults, regardless of age. P-RA, P-IAS and P-LA showed a gradually extending trend with the increase of age, and there were statistically significant differences in P-IAS between the elderly group and the middle- aged group, in P-LA between the middle-aged group and the younger group, between the elderly group and the younger group, and between the elderly group and the middle-aged group, respectively. With the increase of age, the intra-right atrial synchrony, the intra-left atrial synchrony and the inter-atrial synchrony gradually decreased, there were statistically significant differences in the intra-right atrial synchrony between the elderly group and the younger group, in the intra-left atrial synchrony between the middle-aged group and the younger group, between the elderly group and the younger group, and between the elderly group and the middle-aged group, in the inter-atrial synchron between the middle-aged group and the younger group, between the elderly group and the younger group, and between the elderly group and the middle-aged group, respectively. P-RA, P-IAS, P-LA, the intra-right atrial synchrony, the intra-left atrial synchrony and the inter-atrial synchrony were significantly correlated with age, and the intra-left atrial synchrony and the inter-atrial synchrony were the most relevant to age. Conclusion Atrial synchrony changes significantly with age and is closely related to age.