经食管超声心动图检查评估左心耳容积在房颤患者左心耳血栓预测中的应用价值

Application value of transesophageal echocardiography to evaluate left at rial ear volume in predicting left atrial ear thrombosis in patients with atrial fibrillation

目的:探讨经食管超声心动图检查评估左心耳容积在心房颤动(房颤)患者左心耳血栓预测中的应用价值。方法:选取2020年11月至2022年11月间在某医院就诊的房颤患者150例进行研究,其中100例患者未发生左心耳血栓,纳入对照组;50例患者发生左心耳血栓,纳入研究组。全部患者均接受经食管超声心动图检查,比较两组的左心耳超声心动图参数等指标,并分析经食管超声心动图检查评估左心耳容积时各项指标与左心耳血栓形成的相关性。结果:经食管超声心动图检查结果显示,相较于对照组,研究组的左房内径(LAD)更大,差异有统计学意义(P<0.05);相较于研究组,对照组中未出现自发性声学显影(SEC)患者的占比更高,差异有统计学意义(P<0.05);相较于对照组,研究组的左心耳开口最大面积(MA)、开口最大直径(MD)、舒张末期最大容积(EDV)、收缩末期最小容积(ESV)均更大,左心耳峰值排空流速(PEV)与射血分数(EF)均更低,差异有统计学意义(P<0.05)。经食管超声心动图检查评估左心耳容积时,各项指标(LAD、SEC及左心耳MA、MD、EDV、ESV、PEV、EF等)与左心耳血栓形成存在明显的相关性(r=0.815)。结论:通过经食管超声心动图检查评估左心耳容积,可有效预测房颤患者是否会发生左心耳血栓,应用价值较高。

Objective:To investigate the application value of transesophageal echocardiography in evaluating left atrial ear volume in predicting left atrial ear thrombosis in patients with atrial fibrillation(AF).Methods:A total of 150 patients with atrial fibrillation treated in a hospital from November 2020 to November 2022 were selected for this study,100 of whom did not develop left atrial ear thrombosis and were included in the control group.Fifty patients with left auricular thrombus were included in the study group.All patients received transesophageal echocardiography.Left atrial echocardiography parameters and other indicators were compared between the two groups,and the correlation between all indicators and left atrial echocardiography thrombus formation was analyzed.Results:Transesophageal echocardiography showed that the left atrial diameter(LAD)of the study group was larger than that of the control group,and the difference was statistically significant(P<0.05).Compared with the study group,the proportion of patients in the control group without SEC was higher,and the difference was statistically significant(P<0.05).Compared with the control group,the maximum opening area(MA),the maximum opening diameter(MD),the maximum end-diastolic volume(EDV)and the minimum end-systolic volume(ESV)of the left auriculus in the study group were all larger,and the peak drainage velocity(PEV)and ejection fraction(EF)of the left auriculus were lower in the study group,with statistical significance(P<0.05).There was a significant correlation between the indexes(LAD,SEC,MA,MD,EDV,ESV,PEV,EF,etc.)and thrombus formation of the left atrial appendage(r=0.815)in the assessment of the volume of the left atrial appendage by transesophageal echocardiography.Conclusion:Transesophageal echocardiography can effectively predict the occurrence of left auricular thrombosis in patients with at rial fibrillation,which is of high application value.