心房颤动患者复律前后左心房功能变化的超声研究

Study on changes of left atrial function in patients with atrial fibrillation before and after cardioversion by echocardiography

目的 探讨心房颤动 ( AF )复律后左心房功能变化的特点。方法 选择 AF病人 96例 ,按心脏节律转复的方式分为自发性复律 ( A)组 2 4例 ,药物复律 ( B)组 40例及直流电复律 ( C)组 3 2例 ;分别应用超声心动图测定其左心房内径和容积 ,计算左心房主动和被动排空容积 ,并评价左心房功能。结果 AF时所有病人的左心房扩大 ,而恢复窦性心律后 A、B及 C组左心房内径降低者分别为 10 0 %、74%及 5 2 %。 62例左心房机械功能正常患者与 3 4例左心房功能降低患者比较有更强的左心房射血力 ( LAEF ) ,这与复律后左心房内径降低有关。左心房功能异常( L AEF<7达因 )患者左心房内径和容积分别与左心房射血力呈负相关 ( r=-0 .72和 -0 .76,P<0 .0 0 1)。左心房主动排空分数降低而管道容积却增加。结论 心房颤动复律后 。

Objective To evaluate the changes characteristics of left atrial (LA) function in patients with atrial fibrillation (AF) after cardioversion. Methods The initial study population included 96 patients with AF.According to cardioversion pattern the patients were divided into spontaneous cardioversion to sinus rhythm (24 patients), random cardioversion with drugs (40 patients) and cardioversion with direct current (DC) shock (32 patients).Left atrial size and volume were evaluated by echocardiography,LA passive and active emptying volumes were calculated,and LA function was assessed.Results The left atrium was dilated in all patients during AF.The size of the left atrium decreased after restoration of sinus rhythm in 100% of patients with spontaneous cardioversion to sinus rhythm,in 74% of patients reverted with durgs and 52% of patients reverted with DC shock. Left atrial ejection force (LAEF) of 62 patients with a normal mechanical atrial function was higher than that of 34 patients with reduced atrial function,it was associated a marked reduction in LA size after restoration of sinus rhythm.An inverse relation between LA diameter or LA volumes and LA ejection force was observed in patients with LAEF <7dynes ( r =-0.72 or r =-0.76, P <0.001).The LA active emptying fraction was lower,but the conduit volume was increased.Conclusions The delay in the restoration of mechanical atrial function after cardioversion was associated with a persistence of LA dilation.