【摘要】 目的研究孤立性心房颤动(LAF)患者的左房心肌应变特点及总的心房传导时间(PA-TDI)改变,探讨二者之间的关系。方法入选53例LAF患者作为LAF组,选取50名健康志愿者作为对照组。测量两组的常规超声心动图指标,应用组织多普勒方法测定PA-TDI间期,应用二维斑点追踪成像(2D-STE)技术对左房心房肌的应变率进行分析。结果与对照组比较,LAF组左房心肌的左室收缩期应变率(SRs)和左房收缩期应变率(SRa)明显降低(均为P<0.01)。对照组左房心肌SRs与PA-TDI间期呈负相关(r=-0.436,P=0.002),左房心肌SRa与PA-TDI间期呈正相关(r=0.377,P=0.01)。LAF组左房心肌SRs与PA-TDI间期呈负相关(r=-0.468,P=0.001),左房心肌SRa与PA-TDI间期呈正相关(r=0.390,P=0.004)。Logistic多元回归分析显示,PA-TDI可独立预测LAF发生(OR:1.28,95%CI:1.02~1.54,P=0.005)。结论 LAF患者左房应变率降低,PA-TDI间期延长;反映左房结构的应变率指标与反映左房电重构的PA-TDI间期呈正相关;PA-TDI是LAF发生的独立预测因子。更多还原

【Abstract】 Objective To investigate the characteristics of left atrium( LA) strain and the change of total atrial conduction time( PA-TDI) in patients with lone atrial fibrillation( LAF),and to assess relationships between LA strain rate and total atrial conduction time( TACT) measured by tissue Doppler imaging( TDI).Methods Fifty-three LAF patients( LAF group) and 50 healthy volunteers( control group) were enrolled into this study. Transthoracic echocardiography was done on both groups. PA-TDI was measured by TDI while LA segmental strain rate( SR) was assessed by two-dimensional speckle-tracking echocardiography( 2D-STE).Results Compared with the control group,LA myocardial strain rate during LV systole( SRs) and strain rate during atrial contraction( SRa) were significantly decreased in the LAF group( P < 0. 01). In the control group,LA myocardial SRs was negatively correlated with PA-TDI( r =- 0. 436,P = 0. 002). LA myocardial SRa was positively correlated with PA-TDI( r = 0. 377,P = 0. 01). In the LAF group,LA myocardial SRs was also negatively correlated with PA-TDI( r =- 0. 468,P = 0. 001),and SRa was positively correlated with PATDI( r = 0. 390,P = 0. 004). Multivariate logistic regression suggested PA-TDI was an independent predictor for LAF( OR: 1. 28,95% CI: 1. 02- 1. 54,P = 0. 005). Conclusions LASR is decreased and PA-TDI is prolonged in LAF patients. SR,which is a parameter for LA structural,and PA-TDI,which is a factor for LA electrical remodeling,is positively correlated. Prolonged PA-TDI may be an independent predictor for LAF occurrence.更多还原