【摘要】 目的应用超声心动图技术检测左心房功能指数(LAFI),以评价阵发性房颤患者经导管射频消融术(RFCA)前后左心房功能变化。方法对30例因阵发性房颤行射频消融术治疗的患者于术前、术后3 d、术后1个月、术后3个月及术后6个月行超声心动图检查。常规测量左心房前后径(LAD),舒张期二尖瓣血流峰值流速及比值(E峰、A峰、E/A),肺静脉血流峰值流速及比值(S峰、D峰、Ar波、S/D)以及左心室流出道速度-时间积分(LVOT-VTI);应用组织多普勒技术(TDI)测量二尖瓣环舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)及比值(Ea/Aa);应用实时三维超声心动图(RT-3DE)测量左心房最大容积(LAVmax)、左心房收缩期前容积(LAVp)及左心房最小容积(LAVmin),计算左心房被动排空分数(LAPEF)、左心房主动排空分数(LAAEF)、左心房排空分数(LAEF)以及左心房功能指数(LAFI)。结果与术前相比,术后3 d LAFI有下降趋势,但差异无统计学意义(P>0.05),A峰及Aa减低(P<0.05);术后1个月,LAFI增高,LAAEF及LAEF增高(P<0.05);术后3个月LAFI增高,LAD及左心房容积减小,LAAEF、LAPEF、LAEF、A峰及Aa增高(P<0.05);术后6个月LAFI增高,LAD及左心房容积减小,LAAEF、LAPEF、LAEF、A峰及Aa增高,S峰增高,D峰减低(P<0.05)。结论 RFCA术后3 d患者左心房功能出现减低趋势;术后1个月患者左心房功能有部分改善,处于缓慢恢复期;术后3个月及6个月患者左心房功能得到全面改善;LAFI是评价房颤患者射频消融术前后左心房功能变化的一项有价值的指标。更多还原

【Abstract】 Objective To evaluate the change of left atrial(LA) function with the left atrial function index(LAFI) in patients with paroxysmal atrial fibrillation(PAF) after radiofrequency catheter ablation(RFCA) using echocardiography. Methods Echocardiography was performed for 30 paroxysmal atrial fibrillation patients who underwent RFCA pre-operation, 3 days, 1 month, 3 months and 6 months after operation. LA anteroposterior diameter(LAD), 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 and S/D) and left ventricular outflow tract velocity-time integral(LVOT-VTI) were measured by conventional echocardiography. Mitral annular motion velocity and ratio(Ea, Aa and Ea/Aa) were measured by tissue Doppler. The LA maximal, minimal and pre-systolic volume(LAVmax, LAVmin and LAVp) were measured by real time three-dimensional echocardiograph(RT-3DE) respectively. LA passive ejection fraction(LAPEF), LA active ejection fraction(LAAEF), LA ejection fraction(LAEF) and LAFI were calculated. Results Comparing with preoperative, 3 days post-ablation LAFI had a downward trend, but there was no statistical significance(P>0.05), A and Aa were decreased(P<0.05). After 1 month, LAFI, LAAEF and LAEF were improved(P<0.05). After 3 months, LAFI was improved, LAD and volume parameters were decreased, and LAAEF, LAEF, LAPEF, A and Aa were improved(P<0.05). After 6 months, LAFI was significantly improved, LAD, volume parameters, and D were significantly decreased, and LAAEF, LAEF, LAPEF, A, Aa and S were significantly improved(P<0.05). Conclusions LA function was in a deterioration three days after RFCA. LA function was improved partly and recovering slowly 1 month after RFCA, and noticeable improvement can be observed in 3 and 6 months after RFCA. LAFI is a valuable indicator for evaluating LA function in patients with AF before and after RFCA.更多还原