非瓣膜病心房颤动对左心房大小的影响

Effects of nonvalvular atrial fibrillation on left atrial diameter

目的 研究非瓣膜病心房颤动对左心房大小及左心室结构和功能的影响 ,探讨心房颤动与左心房扩大之间的因果关系。方法 选择 32 9例非瓣膜病心房颤动患者 ,根据心房颤动类型及心房颤动发作时间分组 ,比较各组间超声心动图参数。结果 心房颤动发作 1～ 3年组和 3年以上组左心房内径 ( L AD)均大于 1年以下组 ( P<0 .0 5 ,P<0 .0 1) ,而 3年以上组 L AD又大于 1～ 3年组 ( P<0 .0 5 ) ,3年以上组左心室舒张末期内径 ( L VED)大于 1年以下组 ( P<0 .0 5 ) ;持续性心房颤动组 L AD和 L VED均明显大于阵发性心房颤动组 ( P<0 .0 1) ;而持续性心房颤动患者心房颤动发作 3年以上组 L AD大于 1年以下组及 1～ 3年组 ( P<0 .0 1,P<0 .0 5 )。结论 心房颤动本身可引起左心房扩大 ,且左心房扩大常发生在心房颤动持续以后 ,因此转复心房颤动应尽早进行 ;心房颤动对左心室结构及功能也有一定影响 ,且持续性心房颤动的影响较大。

Objective To observe the effects of nonvalvular atrial fibrillation(Af) on left atrial diameter(LAD)and left ventricular structure and function,and the relationship between Af and left atrial enlargement. Methods 329 patients with nonvalvular Af were divided into groups by the type and persisting time of Af.Echocardiographic parameters were compared. Results LAD in Af-persisting more than 3 years group was higher than that of 1～3 years group and less than 1 year group,LAD and left ventricular end-diastolic dimension(LVED)was higher that in 1～3 year group than that of less than 1 year group;LAD and LVED in constant Af group was higher than that of paro- xysmal Af group;LAD of constant Af patients was higher in more than 3 years group than those in other groups. Conclusion Af itself can lead to left atrial enlargement which often takes place after Af becomes constant,so Af should be converted as soon as possible;Af also has effects on left ventricular structure and function,and constant Af has a great effect.