三维经食道超声心动图定量评估房颤患者左心耳功能

Quantitative Evaluation of Left Atrial Appendage Function by Three-Dimensional Echocardiography in Patients with Atrial Fibrillation

目的:应用三维经食道超声心动图(3D-TEE)定量评估房颤患者左心耳功能。方法:对60例房颤患者(AF组)及24例健康志愿者(对照组)行常规经胸超声心动图(TTE)和3D-TEE检查,获取左心耳结构、容积及功能参数,根据TEE检查结果是否有血栓(LAAT)及自发性显影(SEC)将AF组分为LAAT/SEC组及NON-LAAT/SEC组,对上述3组数据进行统计学分析。结果:房颤组左心房内径(LAD)、左心耳开口宽度指数(LAA-WI)、开口面积指数(LAA-OI)、最大容积指数(LAA-VImax)和最小容积指数(LAA-VImin)较正常对照组增大,最大排空速度(PEV)、最大充盈速度(PFV)和射血分数(LAA-EF)较正常组均降低,LAAT/SEC组变化更为明显(均P<0.05)。LAA-EF与PEV呈显著正相关(r=0.53,P<0.01),与LAA-OI负相关(r=-0.37,P=0.01)。结论:3D-TEE参数尤其是LAA-EF可有效定量评估AF患者左心耳功能变化。

Objective:To evaluate the feasibility of three-dimensional echocardiography(3D-TEE)in the assessment of left atrial appendage(LAA)function.Methods:A total of 60 patients with nonvalvular atrial fibrillation(AF group)and 24 healthy volunteers(control group)were examined by transesophageal echocardiography(TTE)and 3D-TEE.The structure,volume and function parameters of left atrial appendage were evaluated.The AF group was divided into the LAAT/SEC group and the NON-LAAT/SEC group according to the results of TEE and spontaneous development(SEC).The data of the three groups were statistically analyzed.Results:Left atrial diameter(LAD)、left atrial appendage width index(LAA-WI)、left atrial appendage open area index(LAA-OI)、left atrial appendage maximum volume index(LAA-VImax)and left atrial appendage minimum volume index(LAA-VImin)in the AF group were increased significantly compared with those of the control group,while peak emptying velocity(PEV)、peak filling velocity(PFV)and left atrial appendage ejection fraction(LAA-EF)were decreased,especially noticeable in the LAAT/SEC group(all P<0.05).LAA-EF was positively correlated with PEV(r=0.53,P<0.01)and negatively with LAA-OI(r=-0.37,P=0.01).Conclusion:3D-TEE parameters,especially LAA-EF,can effectively evaluate left atrial appendage function in AF patients.