CAJ | 학술논문

目的：探讨三维容积法左心耳排空分数、左心耳壁心肌组织速度在左心耳功能评估中的应用价值。方法连续选取心房颤动患者76例，应用经食管超声心动图测量二维面积法和三维容积法左心耳排空分数、左心耳最大排空流速、以及左心耳三个位点(内、外侧壁中点及尖部)的组织速度，行统计分析。结果①超声检查中心律为窦性者上述6个参数值均高于房颤者(P 均<0.05)，不伴左心耳内自发声学显影者6个参数值均高于伴自发声学显影者(P 均<0.05)；②三维、二维法排空分数相关性好(r =0.727)，且二者与左心耳最大排空流速的相关系数近似(二维法：r =0.685、三维法：r =0.632)；③左心耳组织速度中，尖部测值较另两个位点更高(P 均为0.000)，且与其他参数的相关性亦更好。结论三维容积法测量左心耳排空分数切实可行，结果可靠；左心耳壁组织速度的最佳取样位点为心耳尖部。
목적：탐토삼유용적법좌심이배공분수、좌심이벽심기조직속도재좌심이공능평고중적응용개치。방법련속선취심방전동환자76례，응용경식관초성심동도측량이유면적법화삼유용적법좌심이배공분수、좌심이최대배공류속、이급좌심이삼개위점(내、외측벽중점급첨부)적조직속도，행통계분석。결과①초성검사중심률위두성자상술6개삼수치균고우방전자(P 균<0.05)，불반좌심이내자발성학현영자6개삼수치균고우반자발성학현영자(P 균<0.05)；②삼유、이유법배공분수상관성호(r =0.727)，차이자여좌심이최대배공류속적상관계수근사(이유법：r =0.685、삼유법：r =0.632)；③좌심이조직속도중，첨부측치교령량개위점경고(P 균위0.000)，차여기타삼수적상관성역경호。결론삼유용적법측량좌심이배공분수절실가행，결과가고；좌심이벽조직속도적최가취양위점위심이첨부。
Objective To discuss the feasibility and accuracy of left atrial appendage (LAA)ejection fraction by real-time 3 dimensional imaging (3D-EF),and tissue velocity of the LAA wall by tissue Doppler imaging (TDI)via transesophageal echocardiography (TEE)in assessing LAA functions.Methods A total number of 76 patients with atrial fibrillation (AF)were included in the study consecutively and underwent TEE for LAA investigations.3D-EF,fractional area change by 2 dimensional imaging (2D-FAC),peak emptying velocity (PEV),LAA tissue velocity by TDI at the mid-portion of lateral wall (TDI-L),mid-portion of septal wall (TDI-S)and the apical tip (TDI-A)were calculated.Results Statistic analysis showed the following results:1 )2D-FAC,3D-EF,PEV,TDI-L,TDI-S and TDI-A were all significantly higher in patients with sinus rhythm than those with AF during the TEE examinations (all P <0.05),and significantly higher in patients without spontaneous echo contrast (SEC)than those who had SEC (all P <0.05);2)The results of 3D-EF showed a good correlation with 2D-FAC (r=0.727,P =0.000),and their correlations with PEV were similar (2D-FAC and PEV:r =0.685;3D-EF and PEV:r =0.632,both P =0.000);3)TDI-A [(14.95±4.63)cm/s]were significantly higher than TDI-L [(12.62±3.96)cm/s]and TDI-S [(12.68±3.59)cm/s](both P =0.000).The correlations of TDI-A with PEV,2D-FAC and 3D-EF were all marked higher than those of TDI-L and TDI-S (with PEV:r=0.840 vs r=0.564,r=0.524;with 2D-FAC:r=0.701 vs r=0.486,r=0.504;with 3D-EF:r=0.753 vs r=0.493,r=0.522,all P <0.05). Conclusions 3D TEE is feasible and reliable in assessing LAA emptying function.The best location for LAA tissue velocity evaluation is the apical tip.