二维斑点追踪成像评价左心耳封堵术封堵器对心房颤动患者左心室心肌的影响

Effect of the Device of Left Atrial Appendage Closure on Left Ventricular Myocardium in Patients with Non-Valvular Atrial Fibrillation by Two-Dimensional Speckle Tracking Imaging

目的应用二维斑点追踪成像(2D-STI)技术探讨左心耳封堵术(LAAC)封堵器装置对左心室心肌功能的影响。资料与方法回顾性选取2017年1月—2020年10月于上海健康医学院附属周浦医院接受LAAC的非瓣膜性心房颤动患者86例,另选取31例未接受LAAC的非瓣膜性心房颤动患者作为对照组。LAAC组患者于LAAC术前、术后45 d(n=86)、术后12个月(n=57)行二维超声测量左心室收缩功能参数;采用2D-STI技术测量左心室心肌收缩期整体纵向应变(GLS)和整体环向应变(GCS),评估LAAC术前、术后左心室功能和左心室心肌应变值参数的变化。结果LAAC组术前GLS、GCS与术后45 d[GLS:(13.77±3.14)%比(13.85%±3.38)%,t=0.161;GCS:(13.43±3.79)%比(13.30±3.88)%,t=0.222]或术后12个月[GLS:(13.77±3.14)%比(14.39±3.81)%,t=1.061;GCS:(13.43±3.79)%比(12.71%±4.25)%,t=1.059]比较,差异均无统计学意义(P均>0.05)。LAAC组GLS、GCS与对照组比较[GLS:(13.77±3.14)%比(13.81±3.42)%,t=0.059;GCS:(13.43±3.79)%比(14.98±4.10)%,t=1.910],差异均无统计学意义(P均>0.05)。结论非瓣膜性心房颤动患者LAAC术后短期内(45 d)及长期(12个月)封堵器对左心室大小、左心室心肌应变参数均无明显改变。

Purpose To access the effect of the device of percutaneous left atrial appendage closure(LAAC)on left ventricular(LV)myocardium in patients underwent the process of LAAC were accessed by two-dimensional speckle tracking imaging(2D-STI).Materials and Methods Eight-six patients with NVAF who underwent LAAC in Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital from January 2017 to October 2020 were enrolled.Thirty-one patients without LAAC were chosen as the control.LV global longitudinal strain(GLS)and global circumferential strain(GCS)were determined by 2D-STI,respectively.All of the data of LV function,GLS and GCS in LAAC patients were collected and calculated before LAAC and 45 days(n=86)or 12 months(n=57)after intervention of LAAC,to evaluate the changes of LV before and post LAAC.Results Compared with data in the LAAC group before LAAC,GLS and GCS showed no statistical differences significantly before and after 45 days or 12 months of the intervention of LAAC[GLS:(13.77±3.14)%vs.(13.85±3.38)%after 45 days,(14.39±3.81)%after 12 months;t=0.161 and 1.061;GCS:(13.43±3.79)%vs.(13.30±3.88)%after 45 days,(12.71±4.25)%after 12 months;t=0.222 and 1.059](all P>0.05).Moreover,there were no statistical differences significantly in LV systolic function parameters,GLS and GCS among patients with LAAC and without LAAC[GLS:(13.77±3.14)%vs.(13.81±3.42)%,t=0.059;GCS:(13.43±3.79)%vs.(14.98±4.10)%,t=1.910](all P>0.05).Conclusion No significant changes were found on LV myocardium regardless short-term(45 days)or long-term(12 months)after LAAC.