左房应变对非瓣膜性房颤病人左心耳血栓及重度自发显影的预测价值

Predictive value of left atrial strain on left atrial appendage thrombosis and severe spontaneous echo contrast in patients with non-valvular atrial fibrillation

目的:探索无创预测非瓣膜性房颤(NVAF)病人左心耳血栓(LAAT)或者重度自发显影(SSEC)的超声指标。方法:对144例NVAF病人行经胸超声心动图(TTE)及经食道超声心动图(TEE)检查。经胸测定左房整体纵向应变(LAGLS)、左房面积变化分数(LAFAC)、左房排空分数(LAEF)。经食道扫查左心耳内有无血栓或者SSEC分成阳性组及阴性组。探讨经胸测定的左房机械功能参数对LAAT或SSEC的预测价值。结果:左房与左心耳机械功能有较高的一致性,LAGLS是LAAT或SSEC的独立预测因子(OR=0.781,95%CI:0.682~0.893,P<0.01)。结论:LAGLS对NVAF病人LAAT或SSEC具有独立预测价值,可减少不必要TEE操作。

Objective:To explore the ultrasound indicators of predicting left atrial appendage thrombosis(LAAT)or severe spontaneous echo contrast(SSEC)in patients with non-valvular atrial fibrillation(NVAF).Methods:The transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE)in 144 NVAF patients were detected.The left atrial global longitudinal strain(LAGLS),left atrial area change fraction(LAFAC),and left atrial emptying fraction(LAEF)were measured.The patients were divided into the positive group and negative group by esophageal scan for thrombus or severe spontaneous imaging in the left atrium.The value of left atrial mechanical function parameters measured by chest in predicting left atrial appendage thrombus or severe autography were investigated.Results:The mechanical function of left atrial and left atrial appendage was highly consistent,and the LAGLS was an independent predictor of LAAT or SSEC(OR=0.781,95%CI:0.682-0.893,P<0.01).Conclusions:LAGLS has independent predictive value for LAAT or SSEC in NVAF patients,and can avoid unnecessary TEE operation.