实时三维超声心动图联合二维斑点追踪技术评价左心耳封堵器对左心房结构及功能的影响

Evaluation of the effect of the Left atrial appendage occluder on the left atrial structure and function by real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging

目的探讨采用实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)和二维斑点追踪技术(two-dimensional speckle tracking imaging,2D-STI)评价左心耳封堵器对左心房(LA)结构及功能的影响。方法选取86例接受左心耳封堵术(left atrial appendage closure,LAAC)治疗的非瓣膜性房颤(NVAF)患者为LAAC组,另选未接受LAAC治疗的31例NVAF患者为对照组。采用RT-3DE获取LAAC患者术前、术后45天(n=86)、术后12个月(n=57)和对照组患者的左心房容积(LAV)、左心房容积指数(LAVI)、左心房射血分数(LAEF),采用2D-STI获取左心房心肌应变值,比较各组间的差异。结果LAAC组术前与术后45天和12个月比较,LAAC组术前与对照组比较,各组间左心房容积参数和左心房心肌应变值差异无统计学意义(P>0.05)。结论LAAC术后无论短期还是远期均未发现封堵器对左心房的结构和功能有不良影响,提示左心耳封堵器适合于临床应用。

Objective The effect of the left atrial appendage occluder on leftatrial myocardium was detected by real-time three-dimensional echocardiograph(RT-3DE)and two-dimensional speckle tracking imaging(2D-STI).Methods 86 patients with NVAF who underwent LAAC were enrolled.31 patients without LAAC were chosen as the control.The data of LAV,LAVI,LAEF and myocardial strain of LA in LAAC patients were collected and calculated before LAAC,45 days(n=86)and 12 months(n=57)after intervention of LAAC,and also in control group,the differences between them were compared.Results There were no statistically significant differences in left atrial function parameters and myocardial strain between preoperative patients and 45 days or 12 months of postoperative patients,and also between preoperative and nonoperative patients(P>0.05).Conclusion The current research suggests that no any harmful impact of the left atrial appendage occluder can be found on LA myocardium regardless short-term or long-termafter LAAC,which implys that the metal device of LAAC might be suitable for clinical application.