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目的斑点追踪成像(STI)评价非瓣膜病性心房颤动患者左心房重构与卒中的相关关系。方法将60例非瓣膜病性心房颤动(AF)患者按是否卒中分为卒中组和非卒中组;按CHADS2-VAS评分分为高危组、中危组和低危组。常规超声测量左房前后径(LAd)、左房容积指数(LAVI)、左室射血分数(LVEF)、二尖瓣口舒张期流速(E)、二尖瓣环舒张期运动速度(E′),计算E/E′。STI测量左房长轴方向整体应变(Globle-S)、心室收缩期应变率(SRs)、心室舒张期应变率(SRe)。结果(1)卒中组LAVI>非卒中组,LVEF、Globle-S、SRs、SRe低于非卒中组。(2)Globle-S的ROC曲线下面积为0.918,<9.05诊断AF患者发生卒中的灵敏度和特异度为81.72%、88.96%。(3)LAVI高危组>中危组>低危组;Globle-S呈相反趋势。(4)高危组Globe-S<9.05患者卒中发生率为61.9%,≥9.05患者的卒中发生率为12.5%,二者有统计学差异。结论左房结构与功能等参数对AF患者卒中风险评估具有重要临床意义,可作为CHADS2-VAS评分的有效补充。
Objective-speckle tracking imaging (STI) was used to evaluate the relationship between left atrial remodeling and stroke in patients with non-valvular atrial fibrillation. Methods Sixty patients with non-valvular atrial fibrillation (AF) were divided into two groups: stroke group and non-stroke group. According to CHADS2-VAS score, they were divided into high risk group, moderate risk group and low risk group. The left ventricular mass index (LAVI), left ventricular ejection fraction (LVEF), mitral diastolic velocity (E), mitral annular diastolic velocity (E ’ ), Calculate E / E ’. STI was used to measure Globle-S, SRs and SRe in the left atrium. Results (1) Stroke group LAVI> non-stroke group, LVEF, Globle-S, SRs, SRe lower than non-stroke group. (2) The area under the ROC curve of Globle-S was 0.918. The sensitivity and specificity of <9.05 stroke in patients with AF were 81.72% and 88.96%, respectively. (3) LAVI high risk group> moderate risk group> low risk group; Globle-S showed the opposite trend. (4) The incidence of stroke in Globe-S <9.05 patients in high-risk group was 61.9%, and the incidence of stroke in patients ≥9.05 was 12.5%. There was a significant difference between the two. Conclusion The left atrial structure and function parameters of stroke patients with AF risk assessment has important clinical significance, CHADS2-VAS score can be used as an effective complement.