实时三维经食管超声心动图定量评估心房颤动患者左心耳形态及功能改变的临床意义

The clinical significance of real-time three-dimensional transesophageal echocardiography in quantitative evaluation of the morphological and functional changes of the left atrial ear in patients with atrial fibrillation

目的探究实时三维经食管超声心动图(RT-3D-TEE)定量评估心房颤动(AF)患者左心耳(LAA)形态及功能改变的临床意义。方法选取2018年10月至2020年9月于本院检查的60例AF患者作为研究组,另选取同期于本院检查的无AF的60例其他心脏疾病患者作为对照组。所有患者均行RT-3D-TEE定量评估,比较两组LAA形态[LAA最大开口直径(D_(max))、最小直径(D_(min))、直径变化率(D%),LAA开口最大面积(A_(max))、最小面积(A_(min))、面积变化率(A%)]及功能参数变化[LAA舒张末期容积(LAA-EDV)、收缩末期容积(LAA-ESV)、LAA射血分数(LAA-EF)]。结果研究组D_(max)、D_(min)、A_(max)、A_(min)均高于对照组,A%、D%均低于对照组,差异有统计学意义(P<0.05)。研究组LAA-EDV、LAA-ESV均高于对照组,LAA-EF低于对照组,差异有统计学意义(P<0.05)。结论采用RT-3D-TEE定量评估AF患者能获得准确LAA形态及功能状态,为临床诊断提供可靠的依据,值得推广应用。

Objective To explore the clinical significance of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in quantitative evaluation of the morphological and functional changes of the left atrial appendage(LAA)in patients with atrial fibrillation(AF).Methods 60 patients with AF who were examined in our hospital from October 2018 to September 2020 were selected as the study group,and 60 pa-tients with other heart diseases without AF who underwent examination in our hospital during the same period were selected as the control group.All patients underwent RT-3D-TEE quantitative assessment,the LAA morphology(LAA maximum opening diameter[D_(max)],minimum diameter[D_(min)],diameter change rate[D%];LAA maximum opening area[A_(max)]and minimum area[A_(min)],area change rate[A%])and functional parameter changes(LAA end-diastolic volume[LAA-EDV],end-systolic volume[LAA-ESV],LAA ejection fraction[LAA-EF])were compared between two groups.Results The D_(max),D_(min),A_(max),A_(min)of the study group were higher than those of the control group,while A%and D%were lower than those of the con-trol group,the difference was statistically significant(P<0.05).The LAA-EDV and LAA-ESV in the study group were higher than those in the con-trol group,while LAA-EF was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Quantitative assessment of AF patients with RT-3D-TEE can obtain accurate LAA morphology and functional status,provide reliable basis for clinical diagnosis,and is worthy of popularization and application.