非风湿性房颤患者心律平或比索洛尔复律后的左房收缩功能改变

Recovery of Left Atrial Systolic Function of the Patients with Nonrheumatic Atrial Fibrillation after Taking Propafenone and Sotalol

目的 研究非风湿性房颤 (NRH AF)患者经心律平和比索洛尔复律后左房收缩功能的变化。方法 利用超声多普勒观察了 2 3例NRH AF患者分别服用心律平和比索洛尔复律后第 1、30天的心房收缩期二尖瓣血流(MIF)和肺静脉血流 (PVF)变化 ,并与 15例正常人比较。结果 10 0 % (2 3/ 2 3)的患者复律后第 1天A、Z波可探及。两组患者间复律后第 1天的房缩期二尖瓣血流峰速 (Ap1d)、速度积分 (Ai1d)和房缩期肺静脉返转血流峰速(Zp1d)、速度积分 (Zi1d)无显著性差异 ,但均较正常显著减小 (P <0 .0 1)。此后两组患者的Ap、Ai、Zp、Zi都程度不同的增大。但复律后第 30天时两组患者的Ap、Ai、Zp、Zi都仍较正常组显著减小 (P <0 .0 5 )。与心律平组患者相比 ,比索洛尔组第 30天时的Ap30d显著减小 ,且 1个月内Ap、Ai、Zp、Zi的变化率 (△X)也均显著减小 (P <0 .0 5 )。结论 :NRH AF患者经心律平或比索洛尔复律后 1个月内左房收缩功能均不能完全恢复 ,从复律后左房机械收缩功能的改变来看 。

Abstract\ To study and to compare the changes of left atrial systolic function of the patients with nonrheumatic atrial fibrillation after taking propafenone or sotalol. Methods\ Using Doppler echocardiography to observe the changes of MIF and PVF of 23 cases of NRH AF on the 1st day and 30th day after giving them propafenone or sotalol, comparing them with 15 normal people.Results\ The wave A and the wave Z were found in the 23 patients on the first day after cardioversion .Compared with the normal ,the flow of both TMF and PVF at atrial constriction in all patients on the first day after cardioversion were lower(P<0.01).But there wasn't difference between the two groups. There was a gradual increase in the peak A wave velocity , velocity time integrals, the peak Z wave velocity and velocity time integrals during the four weeks in the all patients.Both TMF and PVF at atrial constriction were also lower in the two groups respectively on the 30th day than those in the normal .And the peak A wave velocity ,the peak Z wave velocity on the 30th day and the increased rate of the peak A wave velocity ;the velocity time integrals; the peak Z wave velocity and velocity time integrals within the four weeks in patients taking Sotalol all decresed comparing those taking Propafenone (P< 0.05) . Conclusion\ There is no complete recovery of atrial constriction function during the first month .It could be infered that Propafenone was better than Sotalol in giving pharmacological conversion according to the recovery of atrial constriction function.