经食管实时三维超声心动图在心房颤动患者左心耳解剖形态及功能评价中的应用

Application of Real-Time Three-Dimensional Transesophageal Echocardiography in the Evaluation of Anatomy Morphology and Function of Left Atrial Appendage in Patients with Atrial Fibrillation

目的探讨经食管实时三维超声心动图(RT-3D-TEE)在心房颤动(AF)患者左心耳(LAA)解剖形态及功能评价中的应用。方法 90例接受RT-3D-TEE检查的患者分为AF组和非AF组,将AF组患者进一步分为无SEC亚组、 SEC亚组及TH亚组。比较各组患者的左心耳解剖形态及功能。结果 AF患者的左心耳血栓发生率为30.77%。AF组的LAA-OA、 V-LAA(max和min)、 LAA-v及LAA-EF与非AF组对比, P <0.05; TH亚组V-LAA、 LAA-v及LAA-EF与无SEC亚组对比, P <0.05。AF组的LAA-OA、 LAA-D与Vmax-LAA呈正相关, Vmax-LAA与LAA-v呈负相关。结论 RT-3D-TEE能清晰显示左心耳的结构,精确测量左心耳的各项参数,较好地评价房颤患者左心耳解剖形态及功能。

Objective To explore the application of real-time three-dimensional transesophageal echocardiography （RT-3D-TEE） in the evaluation of anatomy morphology and function of left atrial appendage （LAA） in patients with atrial fibrillation （AF）. Methods 90 cases of patients with RT-3D-TEE examination were divided into the AF group and the non-AF group; The AF group was further divided into the non-SEC subgroup, SEC subgroup and TH subgroup. The anatomy morphology and function of LAA were compared among all the groups. Results The incidence ofthrombus of LAA in AF group was 30.77%. There were statistically significant differences in the LAA-OA, V-LAA （the maximum and minimum）, LAA-v and LAA-EF between AF group and non-AF group （P〈0.05）, and in the V-LAA, LAA-v and LAA-EF between the TH subgroup and non-SEC subgroup （P〈0.05）. The LAA-OA and LAA-D were positively correlated with Vmax-LAA, while Vmax-LAA was negatively correlated with LAA-v in AF group. Conclusions RT-3D-TEE can clearly show the structure of LAA, accurately measure the parameters of LAA, and better evaluate the anatomic morphology and function of LAA in patients with AF.