| 于志琴,李天亮,张晓丽,胡新玲,李小明,高兵兵,张煜茗.二维斑点追踪成像技术评价阵发性房颤患者射频消融术前后左心房功能[J].中国医学影像技术,2019,35(7):1008~1012 |
| 二维斑点追踪成像技术评价阵发性房颤患者射频消融术前后左心房功能 |
| Two-dimensional speckle tracing imaging in evaluating on left atrial function changes in patients with paroxysmal atrial fibrillation underwent radiofrequency catheter ablation |
| 投稿时间：2018-12-27 修订日期：2019-04-25 |
| DOI：10.13929/j.1003-3289.201812154 |
| 中文关键词: 二维斑点追踪成像 心房颤动 心房功能,左 射频消融术 |
| 英文关键词:two-dimensional speckle tracking imaging atrial fibrillation atrial function, left radiofrequency ablation |
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| 中文摘要: |
| 目的 探讨二维斑点追踪成像技术（2D-STI）评价经导管射频消融术（RFCA）前后阵发性房颤（AF）患者左心房功能的变化。方法 对30例因阵发性AF接受RFCA治疗患者（AF组）分别于术前、术后3天、1个月及3个月行超声心动图检查，另选30名健康志愿者为对照组。常规测量左心房前后径（LAD）、二尖瓣舒张早期血流峰值流速（E峰）、二尖瓣环舒张早期速度（Em），计算E/Em；测量左心房收缩前容积（LAVP）、最小容积（LAVmin）和最大容积（LAVmax），计算左心房主动排空率（LAAEF）、左心房被动排空率（LAPEF）；以2D-STI获得左心房各节段应变及应变率曲线，测量并计算左心室收缩期及左心室舒张早、晚期左心房平均峰值应变（mSs、mSe、mSa）、应变率（mSRs、mSRe、mSRa）以及左心房僵硬度（LASt）。比较RFCA前后阵发性AF患者左心房结构和功能的变化。结果 与对照组比较，AF组术前LAD、LAVp、LAVmin、LAVmax、E/Em、LASt增大，LAPEF、LAAEF、E、Em、mSs、mSe、mSa、mSRs、mSRe、mSRa减低（P均<0.05）。AF患者RFCA术前及术后3天、1个月、3个月左心房应变参数及LASt总体差异均有统计学意义（P均<0.05），术后3天mSs、mSe、mSa、mSRs、mSRe、mSRa较术前减低，LASt较术前增高（P均<0.05）；术后3个月mSs、mSe、mSa、mSRs、mSRe、mSRa较术前增高，LASt较术前减低（P均<0.05）；术后1个月、3个月mSs、mSe、mSa、mSRs、mSRe、mSRa较术后3天增高，LASt较术后3天减低（P均<0.05）；术后3个月mSRs较术后1个月增高（P<0.05）。结论 阵发性AF患者RFCA术后3天左心房功能下降，术后1个月辅泵功能有所改善，术后3个月左心房储备、辅泵、管道功能均明显改善。 |
| 英文摘要: |
| Objective To explore two-dimensional speckle tracking imaging (2D-STI) in evaluation on the changes of left atrial function in patients with paroxysmal atrial fibrillation before and after radiofrequency catheter ablation (RFCA). Methods Echocardiography was performed on 30 patients with paroxysmal atrial fibrillation (AF group) treated by radiofrequency catheter ablation in the preoperation and postoperative 3 days, 1 month, 3 months. Thirty healthy volunteers were selected as the control group. The left atrial anteroposterior diameter (LAD), early diastolic transmitral flow velocity (E peak), mitral annular early diastolic motion velocity (Em), left atrial maximum, minimum and pre-systolic volume (LAVmax, LAVmin and LAVP) were measured and E/Em, left atrial active ejection fraction (LAAEF), left atrial passive ejection fraction (LAPEF) were calculated by conventional echocardiography. Left atrial strain and strain rate curves of each segment were obtained by 2D-STI, and the mean peak strain (mSs, mSe, mSa) and strain rate (mSRs, mSRe, mSRa) of the left atrial in the left ventricular systolic, the early diastolic stage and the late diastolic stage, and left atrial stiffness (LASt) was measured and calculated. The changes of the left atrial structure and function in patients with paroxysmal atrial fibrillation before and after RFCA were compared. Results Compared with the control group, LAD, LAVp, LAVmin, LAVmax, E/Em and LASt increased in the AF group, LAPEF, LAAEF, E peak, Em, mSs, mSe, mSa, mSRs, mSRe and mSRa decreased (all P<0.05). There were statistically significant differences in left atrial strain parameters and LASt of patients with paroxysmal atrial fibrillation before and 3 days, 1 month and 3 months after RFCA (all P<0.05). Compared with the preoperative, mSs, mSe, mSa, mSRs, mSRe and mSRa decreased and LASt was increased at 3 days after RFCA (all P<0.05); mSs, mSe, mSa, mSRs, mSRe and mSRa increased, and LASt decreased at 3 months after RFCA (all P<0.05). Compared with the postoperative 3 days, mSs, mSe, mSa, mSRs, mSRe and mSRa increased, LASt decreased (all P<0.05) at 1 month and 3 months after RFCA. Compared with the postoperative 1 month, mSRs increased at 3 months after RFCA (P<0.05). Conclusion The left atrium function of patients with paroxysmal atrial fibrillation decrease at 3 days after RFCA, the pump function improved 1 month after RFCA, and the left atrial reservoir, conduit and pump function improve observably at 3 months after RFCA. |
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