组织速度成像技术对房颤患者左心房、左心耳功能的评价作用

摘要

Objective To observe the evaluation effect of echocardiography and tissue velocity imaging (TVI) tech-nology for assessing left atrial and left atrial appendage function of atrial fibrillation patients.Methods Twenty-nine patients with atrial fibrillation collected from July 2013 to March 2015, they were divided into paroxysmal atrial fibrillation (PAF, 15 patients), persistent atrial fibrillation (PeAF, 14 patients), and 15 patients with esophageal echocardiography with sinus rhythm as controls.Using three-level TVI technique to measure the tissue velocity parameters of 4 segments of the left atrium, the tissue velocity parameters of 8 segments of the left ventricle were measured by TVI technique.Results For the left atrial volume, control groupPAF group >PeAF group,there were significant differences( P <0.05),myocardial systolic velocity and diastolic velocity of the left atrium were control group>PAF group >PeAF group( P <0.05).Compared with the control group, the PAF group and PeAF group’s diastolic peak velocity’s differences were statistically significant ( P <0.05), but PAF group and PeAF group’ s diastolic peak velocity differences had no statistical significance( P >0.05).Left atrial appendage average systolic blood peak velocity and left atrial volume showed a negative correlation ( r =-0.696, P <0.01), and left atrial ejection fraction, average sys-tolic peak velocity, mean diastolic peak velocity of early stage were positively correlated ( r =0.787, r =0.805, r =0.679, all P <0.01).Conclusion Patients with atrial fibrillation’s left atrium and left atrial appendage function decreased and PAF patients more obviously, the level of left atrial function can predict left atrial appendage’ s systolic function, TVI can better as-sess left atrial and left atrial appendage function.%目的：观察超声心动图结合组织速度成像（ TVI）技术对房颤患者左心房、左心耳功能的评价作用。方法2013年7月—2015年3月收集的房颤患者29例，根据病史分为阵发性房颤（ PAF ）组15例、持续性房颤（ PeAF）组14例，选择同时期进行食管超声检查的窦性心律患者15例为对照组。采用经胸超声心动图应用三平面TVI技术测量左心房4个壁中间段的组织速度参数；经食管超声心动图联合应用TVI技术测量左心耳8个节段的组织速度参数，对各组参数进行比较及相关性分析。结果左心房容积对照组＜PAF组＜PeAF组，左心室射血分数对照组＞PAF组＞PeAF组（ P ＜0{．05）。左心房各节段心肌收缩速度、舒张早期速度对照组＞PAF组＞PeAF组（ P ＜0．05）。与对照组相比，PAF组、PeAF组舒张峰值速度差异有统计学意义（ P ＜0．05），但PAF组及PeAF 组间舒张峰值速度差异无统计学意义（ P ＞0．05）。左心耳平均收缩峰值速度与左心房容积呈负相关（ r ＝－0．696， P ＜0．01），与左心房射血分数、平均收缩峰值速度、平均舒张早期峰值速度均呈正相关（ r ＝0．787、0．805、0．679， P均＜0．01）。结论房颤患者左心房及左心耳功能减低，持续性房颤患者更甚，左心房功能的高低对左心耳收缩功能具有预测作用，TVI技术可以较好的评价左心房及左心耳功能。