中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2014年
4期
293-296
,共4页
张晓玲%荣昊%尚艳文%唐红
張曉玲%榮昊%尚豔文%唐紅
장효령%영호%상염문%당홍
超声心动描记术%心房颤动%导管消融术%心房功能,左
超聲心動描記術%心房顫動%導管消融術%心房功能,左
초성심동묘기술%심방전동%도관소융술%심방공능,좌
Echocardiography%Atrial fibrillation%Catheter ablation%Atrial function,left
目的 应用实时三平面超声心动图(RT-3PE)和定量组织速度成像(QTVI)技术评价阵发性心房颤动患者经导管射频消融术(RFCA)前后左心房结构和功能的改变.方法 对82例首次行RFCA的阵发性心房颤动患者,留取RFCA术前1周内及术后1、3、6个月窦性心律状态下的常规及三切面(tri-plane)超声图像进行脱机分析.测量左心房前后径、上下径及左右径(LADap、LADml、LADsi);测量二尖瓣血流频谱峰值流速及比值(E峰、A峰、E/A),以及肺静脉血流频谱峰值流速及比值(S峰、D峰、Ar波、S/D).应用Tri-plane法测量左心房最大容积、收缩期前容积、最小容积(LAVmax、LAVp、LAVmin),并计算左心房被动射血分数(LAPEF)、主动射血分数(LAAEF)、总射血分数(LATEF)及扩张指数(LAexpI),计算左心房6个壁的平均峰值速度(Vs、Ve、Va).结果 与术前相比,术后3、6个月LADap减小(P＜0.05);术后3个月A峰增高,E/A比值减低(P＜0.05);术后6个月除A峰增高,E/A比值减低外,S峰增高,D峰减低,S/D增高(P＜0.05);术后3个月LAVmin减小,LAAEF、LATEF增高(P＜0.05);术后6个月左心房容积均减小,LAAEF及LATEF增高(P＜0.05);术后3、6个月左心房壁平均Va增高(P＜0.05).结论 RFCA术后1个月左心房重构及功能处于缓慢恢复期,术后3、6个月患者的左心房重构及功能得到一定程度的改善.
目的 應用實時三平麵超聲心動圖(RT-3PE)和定量組織速度成像(QTVI)技術評價陣髮性心房顫動患者經導管射頻消融術(RFCA)前後左心房結構和功能的改變.方法 對82例首次行RFCA的陣髮性心房顫動患者,留取RFCA術前1週內及術後1、3、6箇月竇性心律狀態下的常規及三切麵(tri-plane)超聲圖像進行脫機分析.測量左心房前後徑、上下徑及左右徑(LADap、LADml、LADsi);測量二尖瓣血流頻譜峰值流速及比值(E峰、A峰、E/A),以及肺靜脈血流頻譜峰值流速及比值(S峰、D峰、Ar波、S/D).應用Tri-plane法測量左心房最大容積、收縮期前容積、最小容積(LAVmax、LAVp、LAVmin),併計算左心房被動射血分數(LAPEF)、主動射血分數(LAAEF)、總射血分數(LATEF)及擴張指數(LAexpI),計算左心房6箇壁的平均峰值速度(Vs、Ve、Va).結果 與術前相比,術後3、6箇月LADap減小(P＜0.05);術後3箇月A峰增高,E/A比值減低(P＜0.05);術後6箇月除A峰增高,E/A比值減低外,S峰增高,D峰減低,S/D增高(P＜0.05);術後3箇月LAVmin減小,LAAEF、LATEF增高(P＜0.05);術後6箇月左心房容積均減小,LAAEF及LATEF增高(P＜0.05);術後3、6箇月左心房壁平均Va增高(P＜0.05).結論 RFCA術後1箇月左心房重構及功能處于緩慢恢複期,術後3、6箇月患者的左心房重構及功能得到一定程度的改善.
목적 응용실시삼평면초성심동도(RT-3PE)화정량조직속도성상(QTVI)기술평개진발성심방전동환자경도관사빈소융술(RFCA)전후좌심방결구화공능적개변.방법 대82례수차행RFCA적진발성심방전동환자,류취RFCA술전1주내급술후1、3、6개월두성심률상태하적상규급삼절면(tri-plane)초성도상진행탈궤분석.측량좌심방전후경、상하경급좌우경(LADap、LADml、LADsi);측량이첨판혈류빈보봉치류속급비치(E봉、A봉、E/A),이급폐정맥혈류빈보봉치류속급비치(S봉、D봉、Ar파、S/D).응용Tri-plane법측량좌심방최대용적、수축기전용적、최소용적(LAVmax、LAVp、LAVmin),병계산좌심방피동사혈분수(LAPEF)、주동사혈분수(LAAEF)、총사혈분수(LATEF)급확장지수(LAexpI),계산좌심방6개벽적평균봉치속도(Vs、Ve、Va).결과 여술전상비,술후3、6개월LADap감소(P＜0.05);술후3개월A봉증고,E/A비치감저(P＜0.05);술후6개월제A봉증고,E/A비치감저외,S봉증고,D봉감저,S/D증고(P＜0.05);술후3개월LAVmin감소,LAAEF、LATEF증고(P＜0.05);술후6개월좌심방용적균감소,LAAEF급LATEF증고(P＜0.05);술후3、6개월좌심방벽평균Va증고(P＜0.05).결론 RFCA술후1개월좌심방중구급공능처우완만회복기,술후3、6개월환자적좌심방중구급공능득도일정정도적개선.
Objective To evaluate the change of left atrial(LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation using real-time tri-plane echocardiography (RT-3PE) as well as quantitative tissue velocity imaging (QTVI).Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter (LADap),LA mediolateral diameter (LADml) and LA superior-infra diameter (LADsi),early and late diastolic transmitral flow velocity and ratio (E,A and E/A),the peak velocity of pulmonary vein and ratio (S,D,Ar,S/D),the maximum volume of the left atrium (LAVmax),the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram(LAVp),the minimum volume of the left atrium (LAVmin),LA passive emptying fraction (LAPEF),LA active emptying fraction (LAAEF),LA total emptying fraction (LATEF),LA expansion index (LAexpI),average peak velocity of six wall of the left atrium (Vs,Ve,Va).Results After 3,6 months,LADap decreased significantly(P ＜ 0.05) ;3 months of follow up,peak A increased,E/A ratio decreased (P ＜0.05);6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased(P ＜0.05) ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased (P ＜0.05);6 months of follow up,LA volume decreased,LAAEF and LATEF increased (P ＜0.05);3,6 months of follow up,the average Va increased(P ＜0.05).Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.
