CAJ | 학술논문

目的应用实时三维超声心动图评价阵发性心房颤动患者射频消融术后右房大小和机械功能的变化,并探讨右房与左房大小和机械功能变化之间的相关性.方法 35例阵发性心房颤动患者接受射频消融手术.应用实时三维超声心动图、经胸超声心动图及组织多普勒超声心动图分别于术前、术后1月及术后3月测量右房收缩末期容积及面积、右房射血分数、三尖瓣舒张晚期A峰速度、组织多普勒三尖瓣环舒张晚期A'峰速度、三维右房收缩末期容积、三维右房射血分数、左房收缩末期容积及面积、左房射血分数、二尖瓣舒张晚期A峰速度、组织多普勒二尖瓣环舒张晚期A'峰速度、三维左房收缩末期容积、三维左房射血分数.结果 35例患者均成功获得满意的三维超声心动图及组织多普勒图像.左房收缩末期面积与三维左房收缩末期容积从术后1月开始即出现了明显的缩小[分别为(18.8±6.3)cm2对(21.5±6.2)cm2,(38.8±17.0)ml对(46.1±20.0)ml,均P＜0.05].心房机械功能方面,三维左房射血分数在术后1月较术前明显下降,到术后3月逐步上升接近术前水平[(41.1±13.7)%对(51.7±15.9)%,(41.1±13.7)%对(45.6±18.3)%,P＜0.05].右房的大小与机械功能的所有参数术后与术前相比差异无统计学意义.术后1月与3月时,右房容积及机械功能的变化与左房容积和机械功能的变化无明显相关性(r值分别为0.23,0.26,0.32,0.03,P＞0.05).结论实时三维超声心动图能精确定量心房的容积和机械功能.阵发性心房颤动患者射频消融术后左房明显缩小,而右房大小及机械功能均无明显改变.
목적 응용실시삼유초성심동도평개진발성심방전동환자사빈소융술후우방대소화궤계공능적변화,병탐토우방여좌방대소화궤계공능변화지간적상관성.방법 35례진발성심방전동환자접수사빈소융수술.응용실시삼유초성심동도、경흉초성심동도급조직다보륵초성심동도분별우술전、술후1월급술후3월측량우방수축말기용적급면적、우방사혈분수、삼첨판서장만기A봉속도、조직다보륵삼첨판배서장만기A'봉속도、삼유우방수축말기용적、삼유우방사혈분수、좌방수축말기용적급면적、좌방사혈분수、이첨판서장만기A봉속도、조직다보륵이첨판배서장만기A'봉속도、삼유좌방수축말기용적、삼유좌방사혈분수.결과 35례환자균성공획득만의적삼유초성심동도급조직다보륵도상.좌방수축말기면적여삼유좌방수축말기용적종술후1월개시즉출현료명현적축소[분별위(18.8±6.3)cm2대(21.5±6.2)cm2,(38.8±17.0)ml대(46.1±20.0)ml,균P＜0.05].심방궤계공능방면,삼유좌방사혈분수재술후1월교술전명현하강,도술후3월축보상승접근술전수평[(41.1±13.7)%대(51.7±15.9)%,(41.1±13.7)%대(45.6±18.3)%,P＜0.05].우방적대소여궤계공능적소유삼수술후여술전상비차이무통계학의의.술후1월여3월시,우방용적급궤계공능적변화여좌방용적화궤계공능적변화무명현상관성(r치분별위0.23,0.26,0.32,0.03,P＞0.05).결론 실시삼유초성심동도능정학정량심방적용적화궤계공능.진발성심방전동환자사빈소융술후좌방명현축소,이우방대소급궤계공능균무명현개변.
Objective To assess the changes of right atrial size and mechanical function after radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation using real-time threedimensional echocardiography(RT-3DE), and to study the correlation between the changes of left atrial(LA)and right atrial(RA) volume and function. Methods Thirty-five patients with paroxysmal atrial fibrillation were undergone radiofrequency catheter ablation (RFCA) successfully. Transthoracic echocardiography (TTE),tissue Doppler imaging(TDI) and RT-3DE were performed before, 1 month and 3 months after procedure respectively. Late systolic volume and area of RA and LA,ejection fraction(EF) of RA and LA,late diastolic peak velocity of mitral valve inflow, tricuspid valve inflow and late diastolic peak velocity of mitral annulus and tricuspid annulus were recorded. Results The 3DE images of all patients were satisfied.LA max area and 3DE LA max volume were significantly reduced at 1 months and 3 months after procedure compared with basic stage [ ( 18.8 ± 6.3) cm2 vs (21.5 ± 6.2) cm2 , (38.8 ± 17.0) ml vs (46.1 ± 20.0) ml,P ＜ 0.05]. 3DE LA EF also declined markedly at 1 month after RFCA, and restored at 3 months later compared with baseline [(41.1 ± 13.7) % vs (51.7 ± 15.9) %, (41.1 ± 13.7) % vs (45.6 ± 18.3) %, P ＜0.05]. The size and mechanical function of the right atrial after procedure were no obvious changes. There were no evidently correlation between the changes of LA and RA volume and function. Conclusions RT3DE can provide a precise method to quantify the value of atrial volume and function. The LA size and volume are significantly reduced after RFCA in patients with paroxysmal atrial fibrillation, however, the RA size and function are no obvious changes.