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经食管超声心动图检测左心耳功能评估非风湿性房颤的栓塞危险性(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第6期
页码:
466-468
栏目:
论著
出版日期:
2000-12-01

文章信息/Info

Title:
Relationship between left atrial appendage function and embolic risk in nonrheumatic atrial fibrillation assessed by transesophageal echocardiography
作者:
袁建军;  徐红伟;  鲁　豫;  马桂英;  张　静;  黄克钧;  徐　予
河南省人民医院, 河南郑州450003
Author(s):
YUAN Jian-jun;  XU Hong-wei;  LU Yu;  MA Gui-ying;  ZHANG Jing;  HUANG Ke-jun;  XU Yu
He′nan Provincal People's Hospital, Zhengzhou He′nan 450003, China
关键词:
超声心动描记术;  经食管;  心房颤动;  左心耳;  血栓栓塞
Keywords:
echocardiography;  transesophageal;  atrial fibrillation;  left atrial appendage;  thromboembolisp
分类号:
R541.75; R540.45
DOI:
-
文献标识码:
A
摘要:
目的 探讨经食管超声心动图 (TEE)测定左心耳 (LAA )功能用于评估非风湿性心房颤动 (房颤 )患者栓塞危险性的价值。方法 46例非风湿性房颤患者同时接受常规经胸超声心动图 (TTE)及 TEE检查。根据 TEE测定的L AA血流排空速率将患者分为低流速组 (<2 5 cm/ s,n=18)和高流速组 (≥ 2 5 cm/ s,n=2 8) ,对两组间心房血栓和左房自发性超声对比现象 (L ASEC)检出率及其它预示栓塞危险性的临床 ,TTE指标进行对比分析。结果 低流速组心房血栓及 L ASEC检出率显著高于高流速组 (P<0 .0 1)。L AA面积扩大与其排空速率降低密切相关 (r=- 0 .5 44 ,P<0 .0 1)。继往栓塞事件、左室功能不全和左房扩大均以低流速组明显 (P<0 .0 5 ) ,而年龄、高血压病史、糖尿病病史在两组间未存在显著差异 (P>0 .0 5 )。结论 TEE测定左心耳功能有助于区分非风湿性房颤患者中的栓塞高危人群。
Abstract:
AIM To explore the value of transesophageal echocardiographic assessment of left atrial appendage(LAA) function for identifying thromboembolic risk in patients with nonrheumatic atrial fibrillation. METHODS Transthoracic and trnsesophageal echocardiographic examinations were performed in 66 patients with nonrheumatic atrial fibrillation. The patients were divided into two groups according to the LAA blood emptying velocity assessed by transesophageal echocardiography:group I(<25 cm/s, n =18) and group Ⅱ (≥25 cm/s, n= 28). The incidences of left atrial thrombus and spontaneous echo contrast as well as other clinical and echocardiographic factors associated with throboembolism were compared between the two groups. RESULTS In group I, the incidences of atrial thrombus and spontaneous echo contrast were significantly higher than those in group II (P < 0. 01), and LAA en largement was closely correlated with reduced LAA blood velocity ( r= - 0. 544, P < 0. 01). Previous embolic events, left atrial diameter dilatation and left ventricular dysfunction were common in group I than in group II (P < 0. 05) , but no significant differences were observed in age, history of hypertension and diabetes (P > 0.05 ). CONCLUSION Left atrial appendage function assessed by transesophageal echocardiography may be helpful for identifying subgroup of patients with non rheumatic atrial fibrillation at higher thromboembolic risks.

参考文献/References

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[2] The Stroke Prevention in Atrial Fibrillation Invenstigators. Predictors of thromboembolism in atrial fibrillation: Echocardiographic feature of patietns at risk [J]. Ann Intern Med , 1992, 116: 6.

[3] Mugge A, Kuhn H, Nikutta P, et al. Assessment of left atrial appendage function by bip lane transesophageal echocardiography in patients with nonrheumatic atrial fibrillation: Identification of a subgroup of patients at increased embolic risk [J]. J Am Coll Cardiol, 1994, 23: 599.

[4] Atrial Fibrillation Investigators. Risk factors for stroke and efficacy of antith romboembolism therapy in atrial fibrillation analysis of pooled data from five randomized controlled trials [J]. Arch Intern Med, 1994, 154: 1449.

[5] Bath PMW , Prasad A , Bromn MM , et al. Survey of use of anticoagulation in patients with atrial fibrillation[J]. Br Med J ,1993, 307: 1492.

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备注/Memo

备注/Memo:
收稿日期：2000-03-21. 基金项目：河南省科技攻关计划资助项
更新日期/Last Update: 2000-12-01