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目的全方向M型超声(OME)心动图评价房颤患者左心耳功能的应用价值。方法应用全方向性M型超声及定量组织速度成像(QTVI)技术测量左心耳壁三个节段(间隔、侧壁、顶部)峰值运动速度(PV),应用二维超声心动图及频谱多普勒超声技术分别测量左心耳二维面积变化率(2D-FAC)、峰值排空速度(PEV),应用经食管实时三维超声心动图测量左心耳舒张末容积(3D-EDV)、左心耳排空分数(3D-EF)等技术作为评价左心耳功能的指标。结果与对照组比较,阵发性房颤组与持续性房颤组左心耳各壁运动速度、2D-FAC、PEV、3D-EF均降低,以持续性房颤组降低更为显著(P<0.01),3D-EDV增大,以持续性房颤组增大更为显著(P<0.01);相关分析显示OME与QTVI、3D-EF技术测值具有良好相关性(P<0.01),相关系数分别为(r=0.94、0.83)。结论左心耳壁运动速度的变化能够反映房颤患者左心耳壁心肌受损程度,全方向M型超声可定量评估房颤患者左心耳功能。
Objective To evaluate the value of omni-directional M-mode ultrasonography (OME) in assessing left atrial appendage function in patients with atrial fibrillation. Methods Peak velocity (PV) was measured by omnidirectional M-mode ultrasound and quantitative tissue velocity imaging (QTVI) in three segments of the left atrial appendage (interval, side wall and top). Two-dimensional echocardiography and Doppler echocardiography (2D-FAC) and peak evacuation rate (PEV) of left atrial appendage were measured by EUS technique and left ventricular end-diastolic volume (3D-EDV) by transesophageal real-time three-dimensional echocardiography. Scores (3D-EF) and other techniques as indicators of assessment of left atrial appendage function. Results Compared with the control group, the paroxysmal atrial fibrillation group and persistent atrial fibrillation group left atrial appendage velocity, 2D-FAC, PEV, 3D-EF were decreased, the more persistent atrial fibrillation decreased more significantly (P < (P <0.01). The 3D-EDV was increased and increased more significantly in patients with persistent AF (P <0.01). Correlation analysis showed that there was a good correlation between OME and QTVI and 3D-EF The coefficients are (r = 0.94, 0.83) respectively. Conclusion The changes of left atrial appendage velocity can reflect the myocardial damage of left atrial appendage in patients with atrial fibrillation, and all-directional M-mode ultrasound can quantitatively evaluate left atrial appendage in patients with atrial fibrillation.