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目的应用经食管实时三维超声心动图(RT-3DTEE)评价房颤(AF)患者左心耳(LAA)机械功能与峰值速度的变化及两者之间的相关性。方法 30例AF患者及23例窦性心律(SR)患者行RT-3DTEE检查,应用二维面积法、三维面积法及三维容积法分别测量LAA的排空分数(EFA-2D、EFA-3D、EFV-3D),应用脉冲多普勒测量LAA的峰值速度(PEV)。结果 53例患者中LAA为单叶6例,2叶28例,3叶14例,4叶5例;AF组较SR组排空分数及峰值速度均减低,差异有统计学意义(F_(EFA-2D)=7.569,P=0.000;F_(EFA-3D)=3.625,P=0.000;F_(EFV-3D)=11.340,P=0.000;F_(PEV)=4.891,P=0.028),53例患者LAA排空分数与峰值速度呈正相关(F_(EFA-2D)=0.462,P=0.000;F_(EFA-3D)=0.553,P=0.000;F_(EFV-3D)=0.465,P=0.000)。结论 RT-3D TEE能定量评价AF患者左心耳机械功能及峰值速度。
Objective To evaluate the changes of mechanical functions and peak velocity of left atrial appendage (LAA) in patients with atrial fibrillation (AF) by transesophageal real-time three-dimensional echocardiography (RT-3DTEE). Methods Thirty patients with AF and 23 patients with sinus rhythm (SR) underwent RT-3DTEE. The LAA emptying scores (EFA-2D, EFA-3D, EFV-3D), the peak velocity (PEV) of LAA was measured using pulsed Doppler. Results Among 53 patients, LAA was single leaf in 6 cases, 2 leaves in 28 cases, 3 leaves in 14 cases and 4 leaves in 5 cases. The emptying rate and peak velocity of AF group were significantly lower than those in SR group (F_ (EFA F = (EFV-3D) = 11.340, P = 0.000; F PEV = 4.891, P = 0.028), 53 cases The LAA emptying fraction was positively correlated with peak velocity (F_ (EFA-2D) = 0.462, P = 0.000; F_ (EFA-3D) = 0.553, P = 0.000; F_ (EFV_3D) = 0.465, P = 0.000) . Conclusion RT-3D TEE can quantitatively evaluate the left atrial appendage mechanical function and peak velocity in patients with AF.